Areas Of Squamous Cell Carcinoma Research Articles

Induced Expression of Syndecan-1 in the Stroma of Head and Neck Squamous Cell Carcinoma

Syndecan-1 (CD138), a cell-surface heparan sulfate proteoglycan, is involved in cell–cell, cell-matrix interaction and growth factor binding. Loss of expression of syndecan-1 in tumor cells leads to decreased intercellular cohesion, increased potential for tumor invasiveness, and metastatic spread. Furthermore, induction of syndecan-1 expression in the tumor stroma has been postulated to promote tumor angiogenesis via its binding to growth factors such as basic fibroblast growth factor. Although syndecan-1 expression within tumor cells has been investigated in head and neck squamous cell carcinoma, stromal expression has not been studied in detail. We analyzed 38 cases of head and neck squamous cell carcinoma by immunohistochemical staining for syndecan-1 expression within the stroma. The expression of syndecan-1 within tumor cells of various histologic grades of differentiation, squamous cell carcinoma in situ cells, and benign squamous epithelium was also determined. Variable levels of diminished syndecan-1 expression were noted within the dysplastic cells of 9 of 16 (60%) squamous cell carcinoma in situ lesions and in all 38 (100%) invasive squamous cell carcinoma. In general, higher levels of syndecan-1 expression were observed in the well-differentiated tumors, in contrast to significant reduction of expression seen in poorly differentiated tumors. Syndecan-1 expression was observed within the stroma (in fibroblasts) surrounding infiltrating carcinoma cells in 28 of 38 (74%) cases. The intensity of syndecan-1 staining within the stroma showed generally an inverse correlation with the degree of tumor cell differentiation. Syndecan-1 expression was not detected in the stroma beneath normal squamous epithelium or adjacent to areas of squamous cell carcinoma in situ. We conclude that induced expression of syndecan-1 in the stroma surrounding tumor cells of invasive head and neck squamous cell carcinoma is a frequent event. The increased stromal syndecan-1 expression, coupled with its loss from the surface of carcinoma cells, may contribute to tumor cell invasion and the development of metastases.

Inverted papilloma of nose with orbital involvement and malignant transformation

We report two cases of inverted papilloma of nose with malignant transformation and orbital involvement in 60 year and 73 year male patients from Nepal. Medial maxillectomy and orbital exenteration were done in both cases. Histo- pathological examination showed areas of squamous cell carcinoma in inverted papilloma in both of the cases.The dilemma of diagnosis and treatment is discussed with review of literature.

Squamous cell carcinoma in situ (Bowen's disease) in renal transplant patients treated with 5% imiquimod and 5% 5-fluorouracil therapy.

Depending upon the patient's age at transplant, skin type, sun exposure, and the need for immunosuppressive therapy to prevent rejection, there is escalation in the development of cutaneous malignancies in organ transplant patients a number of years after transplantation. Thus, with the expansion in these procedures over the past decades, and the ever-lengthening survival of these patients, we are seeing an increase in cutaneous malignancies in this patient population. To determine if combined therapy with 5% 5-fluorouracil and 5% imiquimod may be useful in the treatment of squamous cell carcinoma in situ. We present five renal transplant patients, all more than 10 years posttransplantation, three with insulin-dependent diabetes, who developed multiple areas of squamous cell carcinoma (SCC) in situ. All these patients were on chronic immunosuppressive chemotherapy to prevent rejection, but were otherwise doing well. All the patients had biopsy-proven SCC in situ on their lower extremities that even in normal patients may be a challenge to treat. We treated these five patients with a combination of a local immune therapy, imiquimod cream, and a topical chemotherapeutic agent, 5% 5-fluorouracil (5-FU), with clearing of the areas of SCC in situ. Although immunotherapy must be used with caution in organ transplant patients to avoid graft rejection, topical imiquimod is a local immune modulator that potentiates local innate and possible adaptive immunity without measurable effects on systemic immunity. In addition, there is evidence that cytokines induced by imiquimod may improve the therapeutic efficacy of topical 5% 5-FU in the treatment of SCC in situ.

Immunhistochemischer Nachweis von CD44v-Proteinen bei präneoplastischen und neoplastischen Veränderungen der Vulva

Purpose : The cell surface glycoproteins of the CD44 family are divided into standard CD44 (CD44 s) and splice variants of CD44 (CD44v). In normal human tissues CD44v expression is mainly restricted to certain epithelia. Its expression could also be demonstrated in human gynaecological malignancies by immunohistochemistry and semi-quantitative reverse transcription PCR. In this study we investigated the expression of CD44v epitopes encoded by the variant exons v5, v6 and v3 to v10 in preneoplastic and neoplastic lesions of the vulva. Method and material: We investigated the expression of CD44v in biopsies of 30 patients with VIN and 11 patients with vulval carcinoma by immunohistochemical APAAP staining. In addition HPV-DNA was tested using PCR on 10 μm thick paraffin sections. We examined samples for HPV 6 and 11 as well as for 16 and 18. Results: In normal vulval keratinocytes CD44v5, CD44v6 and CD44v3-v10 is present in the membranes of the lower two thirds of the epithelium. The same distribution pattern of CD44v is seen in mild and moderate intraepithelial neoplasia of the vulva (VIN I/II). In severe intraepithelial neoplasia of the vulva (VIN III) we observed alterations in the CD44v expression in comparison to normal vulval tissue. The detection of CD44v isoforms is reduced. In squamous cell carcinoma of the vulva CD44v5, CD44v6 and CD44v3-v10 is present in the membranes of carcinoma cells in non-keratinizing areas. In poor differentiated areas of squamous cell carcinoma we found a loss of CD44v expression. CD44v expression is independent of age, histological subtype of VIN III or vulval carcinoma and detection of HPV-DNA type 6/11, 16 and 18. Conclusion: According to our first immunohistochemical results, CD44v expression is not correlated to poor clinical outcome of patients with preneoplastic and neoplastic diseases of the vulva.

P53 gene mutation in N-butyl-N-(4-hydroxybutyl)nitrosamine-induced urinary bladder tumors and N-methyl-N-nitrosourea-induced colon tumors of rats.

We analyzed p53 mutations in 17 N-butyl-N-(4-hydroxybutyl) nitrosamine-induced bladder transitional cell carcinomas (TCCs) with or without areas of squamous cell carcinoma (SCC) of Long-Evans Cinnamon (LEC) and F344 rats, and in 7 N-methyl-N-nitrosourea-induced colon adenocarcinomas of LEC rats by polymerase chain reaction-single strand conformation polymorphism analysis and DNA sequencing. Of these bladder tumors, one TCC with moderately differentiated SCC had a T to G transversion mutation at codon 141, leading to a Val to Gly amino acid change. No p53 mutation was found in colon adenocarcinomas. Thus a p53 gene mutation seems infrequent in these rat bladder and colon carcinogenesis models even in the late stage.

Inverted papillomas that invade the orbit.

We describe 10 patients with inverted papillomas (IPs), uncommon endophytic epithelial tumors that arose in the nose, paranasal sinuses, and lacrimal sac, that invaded the orbit; review the world literature on IP; and discuss treatment options. Patients ranged in age from 49 to 72 years (mean age, 62 years; median age, 66 years). Six patients were men and four were women. Presenting symptoms and signs included a medial canthal mass (n = 5), epiphora/lacrimal drainage obstruction (n = 3), inability to wear eyeglasses (n = 2), diplopia (n = 1), and painful dentures (n = 1). Histopathologic examination was performed in each patient and revealed all patients to have areas with malignant transformation: six patients with IPs that contained areas of squamous cell carcinoma and four with areas of transitional cell carcinoma in the tumor within the orbit. Eight of the patients with IPs had a recurrence after initial resection. In two patients, the IPs were completely excised and did not recur; yet, follow-up was short. Eight patients required orbital exenteration for local control of disease. Nevertheless, local spread of tumor through bone to brain occurred in three patients with orbital involvement. Indeed, IPs that invade the orbit have a high incidence of malignancy and are locally aggressive tumors. Treatment is difficult, and the recurrence rate is high. Early, wide excision of this aggressive tumor provides the best chance of cure.

Transitional Cell Carcinoma with Sarcomatous Elements in the Urinary Tract

We report six cases of carcinoma showing sarcomatous change in the urinary tract examined by conventional histochemistry and immunohistochemistry. All of the cases were transitional cell carcinoma with or without focal squamous cell carcinoma. Sarcomatous components resembling spindle cell sarcoma with a marked myxoid stroma or chondrosarcomatous element were also observed in all cases. The sarcomatous elements were closely associated with the areas of squamous cell carcinoma in three cases. Various histochemical staining procedures demonstrated mesenchymal features in the stroma of sarcomatous areas. By immunohistochemical examination, the epithelial components showed positive reactions for keratin, epithelial membrane antigen and, focally, carcinoembryonic antigen. The sarcomatous components revealed a positive immunoreaction for keratin but lacked other epithelial markers in all cases. Chondrosarcomatous elements in two cases were positive for both keratin and S-100 protein. These findings indicate that sarcomatous elements in carcinoma may represent mesenchymal metaplasia with partial or complete loss of epithelial features. However, further study will be necessary in order to determine whether heterogeneous elements, such as chondrosarcomatous areas, are epithelial or truly mesenchymal in origin.

A clinicopathologic study of intrahepatic cholangiocarcinoma containing a component of squamous cell carcinoma

Eleven cases of cholangiocarcinoma containing a component of squamous cell carcinoma (CC-SCC) were reviewed clinicopathologically in comparison with 82 cases of common cholangiocarcinoma presenting as a pure form of adenocarcinoma (CC-AC). The former type was prone to develop in a rather advanced stage of the disease, as indicated by short survival time, large tumor size, aggressive modes of intrahepatic spreading, and frequent metastasis. Histologically, the area of squamous cell carcinoma ranged from focal to overwhelming. The occurrence of the squamous element could be interpreted as the result of the metaplastic transformation of adenocarcinoma cells because of the intimate coexistence of the two types in the primary and metastatic lesions. It also was suggested that anaplastic carcinoma cells could sometimes differentiate into squamous cell carcinoma. In no instances was there any squamous metaplasia of the bile ducts demonstrated; therefore, there was no supporting evidence for the possibility of squamous metaplasia of the bile duct epithelium and subsequent malignant transformation.

Increased production of fibronectin by fibroblasts from pre-cancerous scars.

The detection of those post-burn scars which have become established pre-malignant lesions is difficult. I describe a highly sensitive enzyme-linked immunosorbent assay for fibronectin (FN) production by fibroblasts from scar tissue. The amount of FN produced by fibroblasts from scar tissue adjacent to an area of squamous cell carcinoma was found to be 30 times that produced by fibroblasts from normal scar tissue. Thus, this method may be a useful indicator of scars which are pre-malignant.

Basal cell carcinoma of the skin with areas of squamous cell carcinoma: Basosquamous cell carcinoma?

Basal cell carcinoma of the skin with areas of squamous cell carcinoma: Basosquamous cell carcinoma?

Basal cell carcinoma of the skin with areas of squamous cell carcinoma: a basosquamous cell carcinoma?

The diagnosis of basosquamous cell carcinoma is controversial. A review of cases of basal cell carcinoma showed 23 cases that had conspicuous areas of squamous cell carcinoma. This was distinguished from squamous differentiation and keratotic basal cell carcinoma by a comparative study of 40 cases of compact lobular and 40 cases of keratotic basal cell carcinoma. Areas of intermediate tumour differentiation between basal cell and squamous cell carcinoma were found. Basal cell carcinomas with areas of squamous cell carcinoma may be called basosquamous carcinoma.

Comparative light and scanning electron microscopic observations of nasal cavity carcinogenesis in rats treated with 1,4-dinitrosopiperazine.

Epithelial lesions in the nasal cavity of male F344 rats appeared as papillary and nodular hyperplasias progressing to invasive carcinomas during administration of 1,4-dinitrosopepirazine (DNP) at a dose of 0.01% in the drinking water. Observations with specific attention to the cells covering the luminal surface of the mucosa were made by scanning electron microscopy at 10-week intervals. After administration of DNP for 20 and 30 weeks three different types of light microscopically identifiable focal lesions, i.e., papillary hyperplasia, nodular hyperplasia and papilloma, of the epithelium in the nasal cavity were distinguished, and after 40 and 50 weeks areas of squamous cell carcinomas were also observed. In the scanning electron microscope, papillary hyperplasia appeared as a nodular elevation of the surface with a smoother appearance than the surrounding nonnodular areas. Areas of nodular (inverted) hyperplasias had irregularly shaped indentions of the surface. Papillomas appeared as pedunculated projections of the surface. Carcinoma presented as a protrusion of irregular cell masses. The surface cells in the areas of papillary and nodular hyperplasias and of papilloma had numerous short microvilli rather uniform in shape (short-uniform microvilli), unlike the normal epithelium in the nasal cavity, which possesses cilia or olfactory vesicles. The microvilli of carcinoma cells were more irregular in shape and size than those of hyperplastic cells (pleomorphic microvilli).

Carcinoma of the esophagus

The geographic high incidence areas of squamous cell carcinoma of the esophagus suggest that a predisposing factor, such as diet or habits of alcohol or tobacco use, may exist. No convincing evidence, however, has evolved as to what this factor might be. The diagnosis is seldom difficult but the natural history of the disease, with invasion or metastases occurring relatively early, makes effective treatment difficult. Other lesions of the esophagus do occur, both benign and malignant-tumors, but proportionately they are less frequent. Mention is made of these. Despite the fact that only 30% of these carcinomas can be resected and the five-year survival of all patients is in the range of 3%, attempts to secure palliation and occasionally complete cure by operation should continue. Most of the described methods of palliation and stated resection have been tried here. In view of this experience, the simplest, most direct, one stage operation is strongly advised in the majority of patients.

LICHEN SCLEROSUS ET ATROPHICUS AND KRAUROSIS VULVAE

To the Editor:\p=m-\Inthe May, 1961, issue of the Archives of Dermatology, Dr. Richard A. Oberfield presents an article on Sclerosus et Atrophicus and Kraurosis Vulvae. He states that patients with lichen sclerosus et atrophicus, including five male patients with involvement limited to the penis, were studied and followed, and that none developed carcinoma. Dr. Oberfield states, furthermore, that lichen sclerosus et atrophicus is not a precancerous lesion, and carcinoma does not develop. I would like to bring to Dr. Oberfield's attention the presentations before the San Francisco Dermatologic Society of a man with lichen sclerosus et atrophicus (George, W. M.: Lichen Sclerosus et Atrophicus, A.M.A. Arch. Derm. 77:138, 1958) and (George, W. M.: Lichen Sclerosus et Atrophicus, A.M.A. Arch. Derm. 79:370, 1959). Aside from classic and bullous lesions of lichen sclerosus et atrophicus of the trunk and extremities, the patient had clinical and microscopically verified lichen sclerosus et atrophicus of the glans penis, sulcus, and foreskin. Squamous cell carcinoma in situ developed in this involved penile area. The tissue showed lichen sclerosus et atrophicus with areas of squamous cell carcinoma in situ. William M. George, M.D. 30 S.E. Eighth St. Miami 32, Fla.