Squamous Cell Adenocarcinoma Research Articles

A case of maxillary malignant ameloblastoma with cervical lymph node metastases of thyroid cancer

Statements of the Problem: We report a case of malignant ameloblastomawith cervical lymph nodemetastases of thyroid cancer. Materials and Methods: A 61-year-old male who had a swelling in his left maxillary and had visited a nearby dental clinic one month before, was referred to our hospital with the initial diagnosis of an ulcer in the left maxillary gingiva. Our preoperative diagnosis was maxillary malignant tumor. The patient had been suffering from mild diabetes and high blood pressure, and had been taking oral medicine to control these conditions. Method of Data Analysis: Two biopsy procedures revealed that the lesion was a malignant tumor. Though the histological type was not identified, adenosquamous cell carcinoma or odontogenic malignant tumor was suspected. We diagnosed it as a maxillary malignant tumor T4N1MO stage IVA. Preoperative selective intra-arterial chemotherapy and radiation therapy were conducted twice for the maxillary tumor. 40mg/body of docetaxel and 100mg/body of cisplatin were given through arteria femoralis respectively by means of the Seldinger method. Radiation therapy of 50Gy was also conducted.Diagnostic imaging showeda lymphnodemetastases in thecervical region. Since thehistological typewas not identified, cervical dissectionwas conducted.Cervical lymphnodemetastases of thyroid cancer was found in one of 32 submandibular lymph nodes. After conducting preoperative selective intra-arterial chemoradiotherapy, an operation was conducted to resect the malignant tumor in the maxillary under general anesthesia. Incision was conducted along the Weber’s incision line. The left maxillary bonewas resected completely while the inferior wall of the orbit was preserved, and split-thickness skin grafting was conducted. Pathological analysis revealed malignant ameloblastoma. A gastric fistula was made for nutritional care during the treatment. Results of Investigation: Although it was difficult to identify the histological type of the tumor by pathological analysis, squamous cell carcinoma, ameloblastoma carcinoma, adenoid cystic carcinoma or malignant ameloblastoma was suspected. Thyroid cancer (papillocarcinoma) was found in one of 32 accessory nerve lymph nodes through cervical dissection. Immunostaining showed a positive reaction to thyrogloblin andTTF-1. Reexamination of the biopsy lesion revealed that the tumorwas infiltrating and increasing in number, while forming alveolar configurations. Comedo-like necrotic focuses were observed in the inside of some alveolar configurations. The tumor cells

Squamous cell carcinoma variants of the upper aerodigestive tract: a comprehensive review with a focus on genetic alterations.

Squamous cell carcinoma of the upper aerodigestive tract is a heterogenous entity. Although conventional squamous cell carcinomas are easily recognized, the morphologic variants of squamous cell carcinoma can present a diagnostic challenge. Familiarity with these variants is necessary because many are associated with unique risk factors and are characterized by specific molecular alterations (eg, nuclear protein in testis midline carcinomas). Perhaps the most important distinction is in identifying viral-related from nonviral-related carcinomas. The accurate diagnosis of these variants is necessary for prognostic and therapeutic reasons. To provide a clinicopathologic overview and summary of the molecular alterations of the common squamous cell carcinoma variants, including verrucous, spindle cell, acantholytic, adenosquamous, basaloid, and papillary squamous cell carcinoma, as well as nuclear protein in testis midline carcinoma, and to discuss the distinguishing features of human papillomavirus- and Epstein-Barr virus-related squamous cell carcinomas. Published peer-reviewed literature. Familiarity with squamous cell carcinoma variants is essential for proper diagnosis and to guide appropriate clinical management. Further insight into the molecular alterations underlying those variants may lead to alterations in existing treatment approaches and to evolution of novel treatment modalities.

Differential clinical characteristics, treatment response and prognosis of locally advanced adenocarcinoma/adenosquamous carcinoma and squamous cell carcinoma of cervix treated with definitive radiotherapy

To compare tumor characteristics and clinical outcome of patients with cervical locally advanced adenocarcinoma (AC)/adenosquamous carcinoma (ASC) and squamous cell carcinoma (SCC). Retrospective study. National Taiwan University Hospital, Taipei, Taiwan. All patients with cervical SCC (n=35), AC or ASC (n=194) with FIGO stage ≥IIB who received definitive radiotherapy or concurrent chemoradiotherapy (CCRT) from January 1995 to December 2009. Medical and histopathological record review. Progression-free survival (PFS), local recurrence-free survival, distant metastasis-free survival, and overall survival (OS). Compared with the SCC subgroup, patients with AC/ASC were significantly younger (p=0.007), more of them without clinical symptoms were diagnosed by abnormal Pap smear findings (p=0.043), and less responded to treatment (p=0.018). After a median follow-up of 59.3months, patients with AC/ASC had worse 5-year PFS (30.0% vs. 47.6%, p=0.044), worse 5-year distant metastasis-free survival (41.5% vs. 69.9%, p=0.005), and trends toward worse 5-year local recurrence-free survival (64.4% vs. 76.2%, p=0.165) and worse 5-year OS (41.3% vs. 58.1%, p=0.090) than patients with SCC. In univariate analysis, early FIGO stage and complete treatment response were significantly associated with PFS and OS. Histology of non-AC/ASC and Point A biologically equivalent doses in 2-Gy fractions >85Gy were significantly associated with better PFS, and CCRT was significantly associated with better OS. In multivariate analysis, complete treatment response and early FIGO stage remained significant factors for predicting better PFS and OS. Cervical AC/ASC may be more aggressive than is SCC. For cervical AC/ASC, more comprehensively effective treatments are warranted.

MiR-17-5p downregulation contributes to paclitaxel resistance of lung cancer cells through altering beclin1 expression.

Non- small- cell lung cancer (NSCLC) is one of the most leading causes of cancer-related deaths worldwide. Paclitaxel based combination therapies have long been used as a standard treatment in aggressive NSCLCs. But paclitaxel resistance has emerged as a major clinical problem in combating non-small-cell lung cancer and autophagy is one of the important mechanisms involved in this phenomenon. In this study, we used microRNA (miRNA) arrays to screen differentially expressed miRNAs between paclitaxel sensitive lung cancer cells A549 and its paclitaxel-resistant cell variant (A549-T24). We identified miR-17-5p was one of most significantly downregulated miRNAs in paclitaxel-resistant lung cancer cells compared to paclitaxel sensitive parental cells. We found that overexpression of miR-17-5p sensitized paclitaxel resistant lung cancer cells to paclitaxel induced apoptotic cell death. Moreover, in this report we demonstrated that miR-17-5p directly binds to the 3′-UTR of beclin 1 gene, one of the most important autophagy modulator. Overexpression of miR-17-5p into paclitaxel resistant lung cancer cells reduced beclin1 expression and a concordant decease in cellular autophagy. We also observed similar results in another paclitaxel resistant lung adenosquamous carcinoma cells (H596-TxR). Our results indicated that paclitaxel resistance of lung cancer is associated with downregulation of miR-17-5p expression which might cause upregulation of BECN1 expression.

Transdifferentiation of lung adenocarcinoma in mice with Lkb1 deficiency to squamous cell carcinoma

Lineage transition in adenocarcinoma (ADC) and squamous cell carcinoma (SCC) of non-small cell lung cancer, as implicated by clinical observation of mixed ADC and SCC pathologies in adenosquamous cell carcinoma, remains a fundamental yet unsolved question. Here we provide in vivo evidence showing the transdifferentiation of lung cancer from ADC to SCC in mice: Lkb1-deficient lung ADC progressively transdifferentiates into SCC, via a pathologically mixed mAd-SCC intermediate. We find that reduction of lysyl oxidase (Lox) in Lkb1-deficient lung ADC decreases collagen disposition and triggers extracellular matrix remodelling and upregulates p63 expression, a SCC lineage survival oncogene. Pharmacological Lox inhibition promotes the transdifferentiation, whereas ectopic Lox expression significantly inhibits this process. Notably, ADC and SCC show differential responses to Lox inhibition. Collectively, our findings demonstrate the de novo transdifferentiation of lung ADC to SCC in mice and provide mechanistic insight that may have important implications for lung cancer treatment.

Contrast-Enhanced Ultrasonograpic Studies on Pancreatic Carcinoma with Special Reference to Staining and Muscular Arterial Vessels

Comparative study of contrast-enhanced ultrasonography (CE-US) and histopathology of surgically resected specimens in 13 patients with pancreatic carcinoma. A time intensity curve was used to determine the percentage brightness increase in cancerous and normal regions and the patients were divided into two groups, hyperperfusion, with a percentage brightness increase over 80% (n=6) and hypoperfusion, with an increase of less than 80% (n=7) on CE-US. The hyperperfusion group included well-differentiated tubular adenocarcinoma, adenosquamous cell carcinoma and acinar cell carcinoma, while all 7 patients in the hypoperfusion group had moderately differentiated tubular adenocarcinoma. Immunological staining (α-SMA and anti-CD34) of the resected specimens showed significantly higher microartery count (MAC) in the hyperperfusion group (p<0.005) than in the hypoperfusion group or normal pancreas. In the normal pancreas, the mean vessel diameter was significantly higher (over 100 μm) than in the hyperperfusion group (30 μm; p<0.005). It was concluded that a muscular arterial vessel density of less than 30 μm is an important factor in determining staining degree and carcinoma progression by CE-US in pancreatic carcinoma.

Pancreatic Adenosquamous Cell Carcinoma with Solitary Liver Metastasis Showing Different Imaging Features

Pancreatic cancer is one of the most lethal malignancies in the world and is the fourth highest cause of cancer deaths in the United States. According to the 2008 annual report of cancer statistics in Korea, malignant pancreatic cancer has the ninth highest incidence rate with a relative 5-year survival rate of 7.6%. The most common pancreatic histologic subtype is adenocarcinoma, which has a poor survival rate and accounts for 80-85% of pancreatic tumors. In contrast, adenosquamous cell carcinoma is a very rare and more aggressive subtype that accounts for 1-4% of all exocrine malignancies of the pancreas (1). The prognosis of pancreatic adenosquamous cell carcinoma is worse than that of invasive ductal adenocarcinoma: merely 1.6-9.8 months. Multidisciplinary treatments including aggressive surgery, intraoperative radiation therapy, and locoregional chemotherapy have also been reported to improve the survival of patients to inhibit liver metastasis and local recurrence especially for advanced unresectable or metastatic tumors. Among these treatments, surgical resection offers the only possibility for improved survival in resectable tumors, statistically significantly (2). Nontheless, the overall survival is more dismal than that of invasive adenocarcinoma. Although adenosquamous carcinoma of the pancreas is a rare subtype, it is important to accurately diagnose it based on radiologic findings considering its dismal prognosis and evaluate the operability. Here, we report the imaging findings related to pancreatic adenosquamous cell carcinoma with solitary liver metastasis in a 56-year-old patient and review the literature. INTRODUCTION Pancreatic Adenosquamous Cell Carcinoma with Solitary Liver Metastasis Showing Different Imaging Features

Metaplastic breast carcinoma with osteogenic component

Metaplastic breast carcinomas (MBC) are rare primary breast malignancies characterized by the co-existence of carcinoma with non-epithelial cellular elements. They can be classified as monophasic spindle cell (sarcomatoid) carcinoma, biphasic carcinosarcoma, adenocarcinoma with divergent stromal differentiation (osseous, chondroid and rarely rhabdoid) as well as adenosquamous and pure squamous cell carcinomas. Nearly all reports portrait women in their forties or older, yet younger affected females in their twenties have been reported. The usual presentation included firm painless breast mass ranging between 1.4 and 14 cm in diameter, with no evidence of loco-regional or distal metastasis. Mammary osteosarcomas are aggressive tumors with a propensity for blood-borne rather than lymphatic spread. Metastatic disease expected to develop at a mean of 10.5 and 14.5 months from the initial diagnosis and demise followed within 20 months of the onset of metastasis. MBC remains a rare entity with poor response to both chemo-radiotherapy, histological diagnosis is challenging yet it is the main stay in outlining the management. The surgical option remains the only successful current treatment in the form of simple Mastectomy to achieve negative margins sparing the patients axillary node dissection.

肉腫様成分を伴った胆嚢腺扁平上皮癌の1例

症例は60歳，男性．右季肋部痛を主訴に近医受診され，腹部超音波検査にて胆嚢腫瘍の疑いにて当院紹介となった．腹部超音波検査・腹部造影CT検査・腹部MRI検査にて，胆嚢に不整型腫瘤と肝S4への浸潤を認め，胆嚢癌の診断で，肝中央2区域（S4+5+8）切除・胆嚢摘出・肝外胆管切除・2群リンパ節郭清を施行した．病理組織検査にて胆嚢粘膜に腺癌成分を認めたが，大部分は扁平上皮癌成分であった．また，一部の腺癌成分から移行する形で紡錘形細胞を主体とする肉腫様成分が混在しており，免疫組織学的に上皮性マーカーであるAE1/AE3が陽性であり，いわゆる癌肉腫と診断した．肉腫様変化を伴った胆嚢腺扁平上皮癌は，予後は極めて不良とされるが，術後補助化学療法としてS-1療法を選択し，現在術後7カ月無再発生存中である．

左腎合併膵切除を施行した膵腺扁平上皮癌の2例

左腎合併膵切除を施行した膵腺扁平上皮癌の2例

A case of adenosquamous cell carcinoma of the lower bile duct

A case of adenosquamous cell carcinoma of the lower bile duct

A Case of Ovarian Metastasis from Microinvasive Adenosquamous Carcinoma of the Uterine Cervix

Background: Ovarian metastasis is rare in cases of early-stage uterine cervical cancer. For the patients with stage 1b cervical cancer, the incidences of ovarian metastasis were 0.22% of squamous cell carcinoma and 3.72% of adenocarcinoma. The safety of ovarian preservation is controversial for young women, although these women may find it important to preserve fertility. Case: A 36-year-old Japanese woman underwent a loop electrosurgical excision procedure for cervical adenosquamous carcinoma with invasion of 0.8 mm in depth and 1 mm in horizontal extent. She wished to preserve her fertility and was therefore followed up without additional treatments. Thirty months after the loop electrosurgical excision procedure, she had 10 cm-diameter ovarian tumors and underwent hysterectomy, bilateral salpingooophorectomy, appendectomy. This ovarian tumor was revealed to metastasis from cervical carcinoma. Conclusion: To our knowledge, this is first reported case of ovarian metastasis with microinvasive adenosquamous cell carcinoma. The pathological characteristics are important for prognosis: frequent small foci of invasion and high atypia.

Surveillance for Recurrent Cancers and Vaginal Epithelial Lesions in Patients With Invasive Cervical Cancer After Hysterectomy

To examine whether women who have had a hysterectomy for cervical cancer may be at an increased risk of vaginal epithelial lesions. We studied 147 patients with invasive cervical carcinoma (76 squamous cell carcinomas [SCCs], 60 adenocarcinomas [ADCs], and 11 adenosquamous cell carcinomas) who were treated by hysterectomy and had vaginal pathologic follow-up for a mean period of 43.3 months. Of the patients, 15.0% (22/147) developed vaginal intraepithelial neoplasia (VAIN) or recurrence after hysterectomy, including two recurrent carcinomas and eight high-grade VAINs. More important, these high-grade VAINs or recurrent carcinomas were detected only in patients with cervical SCC within the first two years after hysterectomy but not in patients with cervical ADC. Eleven (23.4%) of 47 patients had at least one positive high-risk human papillomavirus (hrHPV) testing result during the follow-up period, and VAIN was detected in 54.5% (6/11) of patients with an hrHPV-positive result compared with 16.7% (6/36) with an hrHPV-negative result. Our results indicate that women with cervical cancer are at an increased risk of VAIN besides recurrence, and women with cervical SCC are more prone to high-grade VAIN/recurrence, especially within the first two years after hysterectomy. The significantly increased detection rate of VAINs/recurrence in the hrHPV-positive group suggests vaginal cytology and HPV cotesting might be the preferred method for surveillance in these women.

Adenosquamous Cell Carcinoma (ASC) or Squamous Cell Carcinoma with Mucin-secreting Component (SCM) of the Esophagus in Female Patients: A Case Report and Systematic Review of the Literature

Adenosquamous Cell Carcinoma (ASC) or Squamous Cell Carcinoma with Mucin-secreting Component (SCM) of the Esophagus in Female Patients: A Case Report and Systematic Review of the Literature

Squamous Cell Carcinoma of the Rectum: A Case Report of a Rare Disorder

Purpose: Primary squamous cell carcinoma (SCC) of the GI tract is a rare malignancy with a far lower incidence than primary adenosquamous cell carcinoma of the GI tract. Schmidtmann described the first case in 1919 by presenting a squamous cell carcinoma of the large intestine localized to the cecum. Of the locations described in literature, primary rectal SCC tumors were the most frequent, followed by the right colon. Primary squamous cell carcinoma of the rectum has an incidence 0.1 per 1000 colorectal carcinomas, with fewer than one hundred cases described in literature since 1919. The patient is a 50-year-old male with PMH significant for HIV off HAART and no history of AIDS defining illness, who presented to the ED with complaint left-sided pain, mid abdominal tenderness, and constipation with significant straining to use the bathroom and dark/bloody stools. He reported he had an external rectal condyloma removed four months prior to admission. The patient noted 10 pounds weight loss over last four months. The patient noticed significant constipation, thin stools and in the last month dark blood with bowel movements (never occurred prior), and has had increasing abdominal pain initially mid epigastric, 5/10 aching, but then progressed to right upper abdomen and then diffuse. He had his first occurrence of bright red blood with bowel movement, which prompted admission. The patient's vitals were stable, and on exam, his abdomen was significant for distention, tenderness to mid-epigastric region, hepatomegaly, external hemorrhoids, and guaiac-positive stool. Other systems were normal. Laboratory results were significant for hemoglobin of 7.3 g/dl, albumin of 2.8 g/dl, and corrected calcium of 13.8 mg/dl. Computed tomography (CT) revealed perirectal mass, diffuse lymphadenopathy, and multiple hepatic masses. Colonoscopy with approximately 4 cm non-obstructing firm and friable mass located at the junction of the anal canal and rectum. Rectal mass pathology consistent with invasive, poorly-differentiated squamous cell carcinoma with basaloid features. Due to advanced stages and aggressive nature of his cancer, the patient was started on palliative radiation with 45 Gy in 15 fractions to the anus and 30 Gy in 15 fractions to the liver. Prognosis has been reported very poor in this case.Figure

The Impact of Radiation Therapy After Resection on Survival in Squamous and Adenosquamous Cell Carcinoma of the Rectum

The Impact of Radiation Therapy After Resection on Survival in Squamous and Adenosquamous Cell Carcinoma of the Rectum

Spindle and kinetochore associated complex subunit 1 regulates the proliferation of oral adenosquamous carcinoma CAL-27 cells in vitro

BackgroundThe prognosis of oral squamous cell carcinoma is very poor due to local recurrence and metastasis. This study explores the molecular events involved in oral carcinoma with the goal of developing novel therapeutic strategies. The mitotic spindle is a complex mechanical apparatus required for the accurate segregation of sister chromosomes during mitosis. Spindle and kinetochore associated complex subunit 1 (SKA1) is a microtubule-binding subcomplex of the outer kinetochore that is essential for proper chromosome segregation. In recent years, much attention has been focused on determining how SKA proteins interact with each other, as well as their biological role in cancer cells. However, the precise role of SKA1 in oral carcinoma remains unknown.MethodsIn order to investigate the role of SKA1 in oral cancer, we employed lentivirus-mediated shRNA to silence SKA1 expression in the CAL-27 human oral adenosquamous carcinoma cell line.ResultsDepletion of SKA1 in CAL-27 cells significantly decreased cell proliferation, as determined by MTT and colony formation assays. These results strongly demonstrate that reduced SKA1 protein levels may cause inhibition of tumor formation. The shRNA-mediated depletion of SKA1 also led to G2/M phase cell cycle arrest and apoptosis.ConclusionThis is the first report to show that SKA1 plays an important role in the progression of oral adenosqamous carcinoma. Thus, silencing of SKA1 by RNAi might be a potential therapy for this disease.

Intratumoral localization and activity of 17β-hydroxysteroid dehydrogenase type 1 in non-small cell lung cancer: a potent prognostic factor

BackgroundEstrogens were recently demonstrated to be synthesized in non-small cell lung carcinomas (NSCLCs) via aromatase activity and aromatase inhibitor (AI) did suppressed estrogen receptor (ER) positive NSCLC growth. However, other enzymes involved in intratumoral production and metabolism of estrogens, i.e. 17β-hydroxysteroid dehydrogenases (i.e. 17βHSD1 and 17βHSD2) and others have not been studied. Therefore, in this study, we examined the clinical/ biological significance of 17β-hydroxysteroid dehydrogenases in NSCLCs.MethodologyArchival materials obtained from 103 NSCLC patients were immunohistochemically evaluated using anti-17βHSD1 and anti-17βHSD2 antibodies. The findings of immunohistochemistry were then correlated with intratumoral estrone (E1) and estradiol (E2) concentration, clinicopathological factors and overall survival of the patients. We further employed NSCLC cell lines, A549 and LK87 to study the functional significance of 17βHSD1, in vitro.ResultsA higher 17βHSD1 immunoreactivity tended to be positively associated with aromatase (p=0.057) and tumor stage (p=0.055) whereas a higher 17βHSD2 immunoreactivity was positively associated with a squamous cell and adenosquamous cell carcinomas subtypes (p=0.031), tumor stage (p=0.004), T factor of TNM classification (p=0.010), maximum tumor diameter (p=0.002) and tended to be associated with N factor of TMN classification (p=0.065). A higher 17βHSD1 immunoreactivity was also significantly associated with lower intratumoral E1 concentration (p=0.040) and a higher intratumoral E2/E1 concentration ratio (p=0.028). On the other hand a higher 17βHSD2 immunoreactivity was significantly associated with higher intratumoral E1 concentration (p=0.035). Results of multivariate regression analysis demonstrated an increased 17βHSD1 immunoreactivity in tumor cells as an independent negative prognostic factor (HR= 2.83, p=0.007). E1 treatment in 17βHSD1 positive NSCLC cells, A549 and LK87, resulted in E2 production (p<0.0001) and enhanced cell proliferation, which was abrogated effectively by 17βHSD1 siRNA knockdown (p<0.0001). In addition, aromatase inhibitor treatment resulted in 17βHSD1 up regulation in both A549 and LK87 cells.ConclusionResults of our present study suggest that 17βHSD1 may be considered an important prognostic factor in NSCLC patients and targeting 17βHSD1 activity may further improve the clinical response in estrogen responsive NSCLC patients.

Squamous variant of gallbladder cancer: is it different from adenocarcinoma?

BackgroundLiterature on squamous variants of gallbladder cancer (GBC) is limited. MethodsThis was a retrospective analysis of GBC patients operated on between August 2009 and March 2012. Patients with adenosquamous carcinoma or squamous cell carcinoma were compared with adenocarcinoma for clinicopathologic features and surgical outcomes. ResultsOf the primary GBC patients resected with curative intent, 14 had adenosquamous carcinoma (10) or squamous cell carcinoma (4) (group A), whereas 122 had adenocarcinoma (group B). Abdominal pain was the most common symptom in both groups; however, presentation with vomiting and an abdominal lump was more common in group A (P = .04 and <.01, respectively). Group A had a significantly larger tumor size (7.9 vs 4.8 cm, P = .01) and a higher incidence of adjacent organ involvement requiring extended resections (85.7% vs 26.2%, P < .01). Despite the higher T stage, node-negative disease was significantly higher in group A (42.9% vs 17.2%, P = .03). There was no significant difference in the median survival after curative resection between the 2 groups (28 vs 31 months, P = .24). ConclusionsThe squamous variant of GBC presented at an advanced T stage; however, nodal involvement and distant metastasis were less common. Despite the higher T stage, curative resection could be achieved in the majority with a comparable survival.

Clinical evaluation of early (stage I-II) cervical adenocarcinoma and adenosquamous cell carcinoma treated by radical surgery: What is the difference between squamous cell carcinoma and non-squamous cell carcinoma (non-SCC) of the cervix?

Clinical evaluation of early (stage I-II) cervical adenocarcinoma and adenosquamous cell carcinoma treated by radical surgery: What is the difference between squamous cell carcinoma and non-squamous cell carcinoma (non-SCC) of the cervix?