Diagnosis Of SCC Research Articles

Primary squamous cell carcinoma of the breast: a case report

IntroductionSquamous cell carcinoma (SCC) of the breast is a rare variant of invasive breast cancer that has been classified as metaplastic carcinoma. When a tumor is composed of spindle cells, diagnosis is challenging.Case reportA 42-year-old woman with a large mass in the right breast underwent modified radical mastectomy. A pathological examination revealed a tumor with central necrosis in it. The tumor had a sarcomatoid growth pattern and the cells were spindle-shaped with severe atypicality. Immunohistochemical staining showed that P63, P53, vimentin, and CKpan were positive, whereas estrogen receptor and C-erbB-2 were negative. Ki-67 proliferation index was as high as 90%. Therefore, a diagnosis of SCC of the right breast was made. The patient received eight cycles of postoperative chemotherapy with paclitaxel and carboplatin, followed by seven cycles of radiotherapy. During follow-up, the patient also had a left thyroid tumor, and postoperative pathology suggested microinvasive follicular carcinoma. Since breast surgery, the patient has remained disease-free for more than four years.ConclusionSCC of the breast with spindle cell and sarcomatoid features is rare. The diagnosis of such tumors requires exclusion of tumors with similar histological morphologies.

Study of p40 is superior to p63 for the diagnosis of pulmonary squamous cell carcinoma on cytological smears

Background: Histology and genetically driven management are the current standard in carcinoma lung. Adequate tissue is a challenge in a few cases. While liquid biopsy is an, it’s an always preferred to get an initial cyto/histo morphological confirmation. While the immune-histo chemistry (IHC) is a proven method to differentiate the squamous vs adeno carcinoma, the role of various “immuno-cyto-chemical” makers were not studied widely. Methods: This is a retrospective (July 2018 to December 2018) for random sample collection and prospective (Jan 2019-August 2019) study conducted from in the Department of pathology, govt. chest hospital Osmania medical college, Hyderabad as a part of PG dissertation, 120 subjects with cytological diagnosis of non-small cell lung carcinoma were analyzed during this period and others were excluded. Results: Out of 120 cases 80-adenocarcinoma (ADC) and 40-squamous cell carcinoma (SCC). Most of the patients are in 61-70 years, 20 are 71-80 years, 20 between 51-60 and 10 are between 40-50 years. In this study sensitivity of p63 and p40 is equal, but specificity and positive predictive value are higher for p40 for diagnosis of SCC. Conclusions: Immuno-cyto-chemistry is still a valid option in selected cases where getting a biopsy is difficult. Our findings recommend the use of p40 immuno staining rather than p63 as a squamous cell marker.

MR diagnosis of SCC arising within ovarian cystic teratomas: analysis of mural nodule characteristics

PurposeThis study aims to evaluate and identify magnetic resonance (MR) findings of mural nodules to detect squamous cell carcinoma arising from ovarian mature cystic teratoma (SCC-MCT).MethodsThis retrospective study examined 135 patients (SCC-MCTs, n = 12; and benign MCTs, n = 123) with confirmed diagnoses across five different institutions between January 2010 and June 2022. Preoperative MR images for each patient were independently assessed by two experienced radiologists and analyzed following previously reported findings (PRFs): age, tumor size, presence of mural nodules, size of mural nodule, and the angle between mural nodule and cyst wall (acute or obtuse). Furthermore, this study evaluated four mural nodule features—diffusion restriction, fat intensity, Palm tree appearance, and calcification—and the presence of transmural extension.ResultsThere were significant differences between the SCC-MCT and benign MCT groups in terms of all PRFs and all mural nodule findings (p < 0.01). Among the PRFs, “tumor size” demonstrated the highest diagnostic performance, with a sensitivity of 83.3% and a specificity of 88.6%. A combination of the aforementioned four mural nodule findings showed a sensitivity and specificity of 83.3% and 97.6%, respectively, for the diagnosis of SCC-MCT. Regarding diagnosis based on a combination of four mural nodule findings, the specificity was significantly higher than the diagnosis based on tumor size (p = 0.021). Based on these mural nodule findings, three SCC-MCT patients without transmural invasion could be diagnosed.ConclusionMural nodule MR findings had a higher diagnostic performance than PRFs for SCC-MCT and can potentially allow early detection of SCC-MCTs.Graphical abstract

The Relationship between Mastitis and Antimicrobial Peptide S100A7 Expression in Dairy Goats.

S100A7 is an inflammation-related protein and plays an essential role in host defenses, yet there is little research about the relationship between mastitis and S100A7 expression in dairy goats. Here, according to the clinical diagnosis of udders, SCC, and bacteriological culture (BC) of milk, 84 dairy goats were grouped into healthy goats (n = 25), subclinical mastitis goats (n = 36), and clinical mastitis goats (n = 23). The S100A7 concentration in subclinical mastitis goats was significantly upregulated than in healthy dairy goats (p = 0.0056) and had a limited change with clinical mastitis dairy goats (p = 0.8222). The relationship between log10 SCC and S100A7 concentration in milk was positive and R = 0.05249; the regression equation was Y = 0.1446 × X + 12.54. According to the three groups, the log10 SCC and S100A7 were analyzed using the receiver operating characteristics (ROC) curve; in subclinical mastitis goats, the area under the ROC curve (AUC) of log10 SCC was 0.9222 and p < 0.0001, and the AUC of S100A7 concentration was 0.7317 and p = 0.0022, respectively; in clinical mastitis goats, the AUC of log10 SCC was 0.9678 and p < 0.0001, and the AUC of S100A7 concentration was 0.5487 and p = 0.5634, respectively. In healthy goats, S100A7 was expressed weakly in the alveolus of the mammary gland of healthy goats while expressed densely in the collapsed alveolus of mastitis goats. Moreover, S100A7 expression increased significantly in mastitis goats than in healthy dairy goats. In this research, results showed the effects of mastitis on the S100A7 expression in the mammary gland and S100A7 concentration in milk and the limited relationship between SCC and mastitis, which provided a new insight into S100A7's role in the host defenses of dairy goats.

Seven Plus One Steps to Assess Pigmented Nail Bands (Melanonychia Striata Longitudinalis).

Melanonychia striata longitudinalis might involve one or more fingers and/or toes and might result from several different causes, including benign and malignant tumors, trauma, infections, and activation of melanocytes that might be reactive or related to the pigmentary trait, drugs and some rare syndromes. This broad differential diagnosis renders the clinical assessment of melanonychia striata particularly challenging. Nail matrix melanoma is relatively rare, occurs almost always in adults involves more frequently the first toe or thumb. The most common nail unit cancer, squamous cell carcinoma / Bowen disease (SCC) of the nail matrix is seldom pigmented. Histopathologic examination remains the gold standard for melanoma and SCC diagnosis, but excisional or partial biopsies from the nail matrix require training and is not routinely performed by the majority of clinicians. Furthermore, the histopathologic evaluation of melanocytic lesions of the nail matrix is particularly challenging, since early melanoma has only bland histopathologic alterations. Dermatoscopy of the nail plate and its free edge significantly improves the clinical diagnosis, since specific patterns have been associated to each one of the causes of melanonychia. Based on knowledge generated and published in the last decades, we propose herein a stepwise diagnostic approach for melanonychia striata longitudinalis: 1) Hemorrhage first 2) Age matters 3) Number of nails matters 4) Free edge matters 5) Brown or gray? 6) Size matters 7) Regular or irregular and, finally, "follow back".

Breast implant capsule-associated squamous cell carcinoma: A systematic review and individual patient data meta-analysis

New concerns have been raised by the US Food and Drug Administration regarding breast implant capsule-associated squamous cell carcinoma (BICA-SCC) but very little is known about this emerging topic. To gain a better understanding of the disease, a systematic review and individual patient data meta-analysis of patients with BICA-SCC were performed. PubMed, Embase, and Cochrane were searched from inception to 26th February 2023 for studies including patients with BICA-SCC. Individual patient data were extracted and pooled. Risk of bias was assessed using the Joanna Briggs Institute critical appraisal tool. A total of 16 studies reported 19 patients with BICA-SCC, commonly presented with swelling (84.2%), pain (73.7%), and erythema (21.1%). The median age at SCC diagnosis was 52.0 (interquartile range [IQR] 46.0-60.0) years. The median time from breast augmentation to SCC diagnosis was 20.0 (IQR 15.0-35.0) years. The majority of patients (68.4%) were found to have extracapsular spread at SCC diagnosis. All patients with breast implants in situ underwent implant removal with at least 60.0% of patients undergoing capsulectomy. The mean follow-up period was 17.6 months with 1-year overall survival of 80.8% and 1-year disease-free survival of 53.0%. While rare, surgeons should counsel patients on the risks of malignancy including BICA-SCC before breast implantation and consider the possibility of BICA-SCC when treating patients with late-onset peri-implant changes. A centralized registry is needed to better understand and improve outcomes in patients with BICA-SCC.

BI07 Outcomes of oral squamous cell carcinoma following haematopoietic stem cell transplantation

Abstract Haematopoietic stem cell transplant (HSCT) recipients are at increased risk of malignancies, including cancers of the oral cavity, with a reported observed-to-expected ratio of 10.7, accounting for 14% of all solid tumours following HSCT. We report 10 cases of oral squamous cell carcinoma (SCC; 2016–2022) in HSCT recipients from a single tertiary centre [nine men and one woman; median age at diagnosis 52 years (range 27–66)]. Thirty per cent were ex-smokers and 10% current smokers. Prior to HSCT, 50% had reduced intensity conditioning, 40% had myeloablative conditioning and 10% had both. Eighty per cent were recipients of sibling allografts and 20% were recipients from matched unrelated donors. Ninety per cent had a history of chronic graft-versus-host disease (GVHD), with affected sites including the mouth (n = 6), skin (n = 6), eyes (n = 5), lungs (n = 4), kidneys (n = 3) and liver (n = 1). Forty per cent had active severe manifestations of oral GVHD. Treatments used for oral GVHD included topical immunosuppression (n = 5), oral immunosuppression (n = 6) and extracorporeal photopheresis (ECP; n = 2). Median latency from HSCT to oral SCC diagnosis was 10 years (range 4–22). At the time of SCC diagnosis, 20% were not taking immunosuppressants, 20% were being treated with topical corticosteroids and 50% with oral immunosuppression, and one patient was recently treated with ECP. Examination findings at SCC diagnosis included induration, ulceration, tenderness, bleeding, hyperkeratosis, speckling and lymphadenopathy (n = 1). Fifty per cent were asymptomatic. In 40% of cases, a previous biopsy showed hyperplastic or dysplastic changes. The commonest sites of SCC were the tongue (n = 4) and buccal mucosa (n = 3). The disease stage (TNM) at presentation ranged from T1N0M0 to T4N2M0. Sixty per cent of cases were T3 or T4 and 40% had nodal involvement. Management included radical surgical resection in 90% of cases; 10% received adjuvant radiotherapy and 10% chemoradiotherapy. One patient with an SCC on the lower lip underwent resection using Mohs micrographic surgery. Median duration of follow-up for the cohort was 0.8 years (range 0.4–5.7) with a 50% mortality rate. In our cohort, median survival following oral SCC diagnosis was 0.8 years (range 0.4–5.0) and SCC-specific mortality was 30% (n = 3). We report the largest UK case series, to the best of our knowledge, of oral SCC post-HSCT. The data show a long latency from HSCT to the onset of oral SCC, highlighting the importance of regular, active oral surveillance by haematologists, dermatologists, oral specialists and dentists. This follow-up is recommended irrespective of the severity of GVHD and length of iatrogenic immunosuppression. Intensive surveillance is indicated in groups at higher risk with a history of chronic oral GVHD.

EPIDEMIOLOGY, RISK FACTORS, AND SOCIAL DETERMINANTS OF PATIENTS WITH EPIDERMOID CARCINOMA OF ORAL CAVITY AND OROPHARYNX

Objective To analyze the risk factors, social determinants, and epidemiology of squamous cell carcinoma in the oral cavity and oropharynx. Study Design Retrospective cross-sectional study that was carried out through the collection of data from physical and digital medical records. A total of 555 patients with oral cancer with a date of admission from 2010 to 2020 and 625 patients with oropharyngeal cancer from 2010 to 2018 were selected, a total sample of 1180 patients, selected for convenience. Results The profile of patients diagnosed with SCC of the oral cavity and oropharynx was composed of men, white-race, with a level of education ranging from complete and incomplete elementary school, mean age of 59 years, whose primary site was the tongue. In this case, the estimated survival in years for patients with cancer of the oral cavity was approximately 5 years and 3 years for cases of oropharynx. Conclusion Advanced stages "III and IV" influenced the prognosis and impacted the overall survival of the two strata. Smoking and alcohol consumption were associated with the profile of affected individuals and there is a growing number of young adults under 59 years of age with the diagnosis of oropharyngeal SCC associated with HPV. To analyze the risk factors, social determinants, and epidemiology of squamous cell carcinoma in the oral cavity and oropharynx. Retrospective cross-sectional study that was carried out through the collection of data from physical and digital medical records. A total of 555 patients with oral cancer with a date of admission from 2010 to 2020 and 625 patients with oropharyngeal cancer from 2010 to 2018 were selected, a total sample of 1180 patients, selected for convenience. The profile of patients diagnosed with SCC of the oral cavity and oropharynx was composed of men, white-race, with a level of education ranging from complete and incomplete elementary school, mean age of 59 years, whose primary site was the tongue. In this case, the estimated survival in years for patients with cancer of the oral cavity was approximately 5 years and 3 years for cases of oropharynx. Advanced stages "III and IV" influenced the prognosis and impacted the overall survival of the two strata. Smoking and alcohol consumption were associated with the profile of affected individuals and there is a growing number of young adults under 59 years of age with the diagnosis of oropharyngeal SCC associated with HPV.

Wearable based monitoring and self-supervised contrastive learning detect clinical complications during treatment of Hematologic malignancies

Serious clinical complications (SCC; CTCAE grade ≥ 3) occur frequently in patients treated for hematological malignancies. Early diagnosis and treatment of SCC are essential to improve outcomes. Here we report a deep learning model-derived SCC-Score to detect and predict SCC from time-series data recorded continuously by a medical wearable. In this single-arm, single-center, observational cohort study, vital signs and physical activity were recorded with a wearable for 31,234 h in 79 patients (54 Inpatient Cohort (IC)/25 Outpatient Cohort (OC)). Hours with normal physical functioning without evidence of SCC (regular hours) were presented to a deep neural network that was trained by a self-supervised contrastive learning objective to extract features from the time series that are typical in regular periods. The model was used to calculate a SCC-Score that measures the dissimilarity to regular features. Detection and prediction performance of the SCC-Score was compared to clinical documentation of SCC (AUROC ± SD). In total 124 clinically documented SCC occurred in the IC, 16 in the OC. Detection of SCC was achieved in the IC with a sensitivity of 79.7% and specificity of 87.9%, with AUROC of 0.91 ± 0.01 (OC sensitivity 77.4%, specificity 81.8%, AUROC 0.87 ± 0.02). Prediction of infectious SCC was possible up to 2 days before clinical diagnosis (AUROC 0.90 at −24 h and 0.88 at −48 h). We provide proof of principle for the detection and prediction of SCC in patients treated for hematological malignancies using wearable data and a deep learning model. As a consequence, remote patient monitoring may enable pre-emptive complication management.

Metastatic squamous cell carcinoma of the lung to the thyroid gland presented as nodular goiter: a rare case report.

A 58-year-old male patient presented with bilateral neck swelling. Fine needle aspiration is performed and was undetermined. Ultrasonography of the neck demonstrated multiple hypoechoic nodules with thyroid enlargement. The patient was diagnosed with nodular goitre and he underwent a total thyroidectomy. Microscopically, the Hematoxylin and eosin-stained sections revealed thyroid follicles with sheets composed of polygonal cells with pleomorphic nuclei, prominent nucleoli, and a moderate amount of eosinophilic cytoplasm. Keratin pearls were present. Based on histopathological and clinical findings, the final diagnosis was metastatic SCC to the thyroid gland. Clinically, patients with thyroid metastasis presented with nonspecific symptoms such as thyroid nodule or goitre, cervical discomfort, dyspnoea, dysphagia, or dysphonia. Chemotherapy is used in the case of a poly metastatic tumour and radiotherapy as a palliative treatment whereas radioiodine treatment is not indicated for thyroid metastases. Diagnosis of SCC in the thyroid gland as a primary or metastatic neoplasm is a significant challenge. In the absence of specific clinical or radiological signs, pathological studies remain the gold standard for diagnosis.

Evaluating the Clinicopathologic Parameters of Tongue Squamous Cell Carcinoma based on its Local Distribution.

Oral squamous cell carcinoma (OSCC) is one of the most common oral lesions and the tongue is one of the most common areas involved. The aim of this study was to evaluate the clinicopathologic feature of tongue SCCs based on its local distribution. In this cross-sectional study, clinical data such as age, gender, location, and clinical appearance were extracted from the archives of the Oral Pathology Department, Isfahan Dental School, registered with a definitive diagnosis of tongue SCC during 2005-2019. Then, 34 specimens were selected for histopathological evaluation in a simple random way. The histopathologic slides were examined to determine the grade of tumor malignancy. The data were entered into SPSS23 software and analyzed by Chi-square, Fisher exact, One-way ANOVA, and Non-parametric tests. P value <0.05 was considered significant. Of the 275 OSCCs, 68 samples were tongue SCC. The mean age of patients was 61.7 ± 15 and 61.8% were women. The most common clinical manifestations were exophytic lesions (42.6%) and the most common site was the lateral border of the tongue (36.8%). The results did not show a significant relationship between the clinicopathologic feature including mean age (p = 0.766), gender (p = 0.338), clinical presentation (p = 0.434), grade of malignancy (p = 0.763) and location. But, among the histopathological parameters, the pattern of invasion (p = 0.047) was significantly associated with the local distribution. Given that most OSCCs had moderate differentiation of malignancy, identification of clinical features is needed. Attention to the pattern of invasion and location on the tongue can be effective in determining the therapeutic approach.

Squamous Cell Carcinoma in the Setting of Hidradenitis Suppurativa: A Retrospective Review of the Literature

Background. Marjolin ulcer is an SCC arising from chronic inflammatory tissue. Such ulcers pose a high risk for metastasis; the 5-year survival rate of 40% to 69% suggests that improvement is possible with early diagnosis. Objective. To raise awareness and update education in the medical community regarding this manifestation of SCC. Methods. The authors performed a retrospective literature review specifically for SCC arising in the context of HS. A PubMed search yielded 81 articles reporting SCC in the context of HS from 1958 to November 2022, with a total of 123 cases. The authors’ additional patient, who was treated in practice, is included as Case 1, bringing the total number of patients to 124. Results. Seventy-three percent of patients were male. The mean age at the time of SCC diagnosis was 53 years ± 10.25 standard deviation. The mean interval between HS diagnosis and SCC development was 24.4 years ± 11.33. Thirty-six percent of patients had metastatic disease. Of the 102 cases that included details on life and death, 58 were noted to have died; of those 58, 60% died within the first year following diagnosis. Conclusion. Given the poor prognosis of Marjolin ulcer, with rapid progression after diagnosis, frequent visual examination and biopsies with a high index of suspicion for HS are recommended to identify SCC prior to metastatic transformation and subsequent unresectable disease. If surgical intervention is performed in the management of HS, tissue should always be sent for pathologic examination.

Squamous cell carcinoma associated with an active cutaneous leishmaniasis in immunocompetent patient: case presentation of an unlikely association and literature—review

BackgroundAssociation between leishmaniasis and malignancy can be classified into four categories: leishmaniasis mimicking malignancy, leishmaniasis co-existing with malignancy, malignancy developing in patients with leishmaniasis scar, and leishmaniasis developing in patients with malignancy. In immunocompetent patients, the main form of association is cutaneous squamous cell carcinoma (cSCC) developing within cutaneous leishmaniasis scar years after cutaneous leishmaniasis is cured. Association of active cutaneous leishmaniasis and cSCC is exceptional, we are aware of two more cases.Case presentationA 30-year-old man presented with 2 years history of an unhealed wound on the dorsum nasi. As there still exist few sites of leishmaniasis in Morocco, systematic screening for leishmania was performed. Leishmania bodies were identified on slit skin smear by Giemsa staining. The patient received local antibiotic and on-site injections of 4 cc of meglumine antimonate for 2 months without any improvement. The lesion volume has increased significantly, a biopsy revealed an invasive squamous cell carcinoma. After staging assessment, the patient underwent a complete removal of the nasal tumor with a 1-cm margin, associated with right modified radical neck dissection. Histopathological examination confirmed the diagnosis of SCC with no lymph nodes metastasis. Nasal reconstruction was performed 2 weeks later using a frontal flap. Oncology meeting board advised adjuvant radiation on the tumor. The patient is followed up regularly and remains free of disease for a year now.ConclusionAlthough many cancers are related to infection (viral or parasitic), there is no proven link between leishmaniasis and malignancy. However, there are many etiopathogenic theories based on pathology finding that involve chronic inflammation inducing dysplasia, mitotic abnormalities, and expression of p53.

Nasal Extranodal Natural Killer/T-cell Lymphoma Imitating Squamous Cell Carcinoma: A Case Report.

Nasal extranodal NK/T-cell lymphoma (NNKTL) is a lethal disease due to poor prognosis with rapid progress. A 56-year-old man complained of left nasal obstruction and blood-stained nasal drip for two months. Incisional biopsies were performed at the outpatient department three times, and the diagnosis of SCC was made. The patient underwent wide excision of the entire lesion via endoscopic sinus surgery with navigation. Final pathologic report revealed NNKTL. Pathological examination of the tumor revealed overlying epithelium presenting as pseudoepitheliomatous hyperplasia (PEH), which mimicked SCC invasion, with infiltration of atypical lymphocytes in the deeper sections. Immunohistochemistry supported the diagnosis of NNKTL. Chemoradiotherapy was administered, and a complete response was achieved at the two-year follow-up. The correct diagnosis of NNKTL is essential for prompt treatment and prevention of superfluous surgery. Although the link between PEH and NNKTL may lead to a misdiagnosis of SCC, multiple large and deep biopsies can prevent this dilemma. A biopsy showing ulceration or necrosis can indicate PEH and imply potential malignancy. Repeated biopsies and complete immunohistochemical studies are important for diagnosing NNKTL.

Adenoid (Acantholytic) squamous cell carcinoma of the alveolar ridge: A rare case report

Adenoid squamous cell carcinoma (ASCC) is a one of the histological variants of oral squamous cell carcinoma with a rare occurrence of less than 4% of all the cases. The tumour has a slight male predilection with lower lip being the most affected site. ASCC is said to have a varied biologic behaviour which accounts for its ability to metastasize to distant sites and hence has poor prognosis. The histopathology shows numerous duct-like structures with central acantholytic cells. Distinct cytological atypia is seen which aids in diagnosis of SCC. Special stains help in differentiating the tumour from other variants of SCC. The presented case of a 70-year-old female emphasizes the importance of histopathogical examination of the unusual and rarely observed ASCC which can be missed due to similarities with other entities. Recurrence rates being very high, proper treatment starting with definitive diagnosis is imperative.

33407 Accuracy of clinical-dermatoscopic versus dermatopathologic diagnosis of melanoma and nonmelanoma skin cancer

Results from a retrospective, quantitative, cross-sectional study to assess the agreement and accuracy of the clinical dermatoscopic diagnosis of melanoma and nonmelanoma SC in comparison with dermatopathologic examinations. In total, 3205 patients were evaluated, with a 67-year mean age. Of these patients, 1603 (50.1%) had a clinical-dermatoscopic hypothesis of AC, with 859 (53.4%) being female and 744 (46.6%) being male patients. Of the suspected cases, 1300 had a clinical-dermatoscopic diagnosis of BCC; 230, SCC; 34, MM; and 39, keratoacanthoma (KA), with a dermatopathologic confirmation of 90.85%; 67.39%; 93.5%; and 85.64%, respectively. The clinical dermatoscopic versus dermatopathologic agrement for all the SC was statistically significant, according to Kappa coefficient and chi-square test. For KA, our accuracy was 85.64%, and these data are the first publication that correlate the clinical dermatoscopic suspect of KA with dermatopathologic confirmation. Our findings show our BCC clinical accuracy (90.85%) is in accordance with the literature. However, for SCC and MM, we had an accuracy greater than what had been published until then, respectively, 67.39 and 93.5%. In conclusion, an exact diagnosis of SCC depends on clinical, dermatoscopic, and histopathologic criteria. Likewise, MM, in which clinical diagnosis’ assertiveness is only 76%, SCC’s clinical diagnosis may be considered a fragile issue because KA is often confused with SCC. In these cases, dermatoscopy has the ability to speed up the therapeutic management of SC which needs more immediate management, even more so when the dermatopathologic diagnosis, the gold-standard tool for diagnosing SC, may be delayed or not available.

Negative terpinen-4-ol modulate potentially malignant and malignant lingual lesions induced by 4-nitroquinoline-1-oxide in rat model.

Our aim was to verify the modulative TP-4-ol capacity in 4-nitroquinoline-1-oxide induced oral rat cancer. The stereoisomers of TP-4-ol were used against the human tongue squamous cell line and the negative stereoisomer showed lower IC50. Thirty-one Holtzman rats (120-130g) were cancer-induced by 4-nitroquinoline-1-oxide (4-NQO/8weeks/25ppm) and 32 Holtzman rats (120-130g) were used to healthy and TP-4-ol toxicity experiments. Six groups were used, healthy, 0.1nL/g of TP-4-ol, 8nL/g of TP-4-ol, 4-NQO, 4-NQO + 0.1nL/g of TP-4-ol, and 4-NQO + 8nL/g of TP-4-ol. We performed the toxicity analysis by biochemical and histopathological analysis. The biochemistry analysis includes alkaline phosphatase (ALP), alanine aminotransferase (ALT), aspartate transaminase (AST), urea, and creatinine and the histopathology analysis includes the liver, kidney, lung, and spleen. Specifically, for malign modulation, we performed a macroscopic and microscopic analysis. The group exposed to 0.1nL/g of TP-4-ol demonstrated a reduced risk of malignancy in dysplasia considering the criteria of architecture and cytology. Similarly, a drop of percentual rats with SCC diagnosis was observed in 4-NQO + 0.1nL/g (41.6%) when compared to 4-NQO (87.5%). Moreover, the 4-NQO group presented a median of 2.62 SCC/rat and the 4-NQO + 0.1nL/g demonstrated a median of 0.75 SCC/rat. For toxicity analysis, 4-NQO + 0.1nL/g showed focal necrosis in the kidney and 4-NQO showed lung hemorrhagic areas. The concentration of 0.1nL/g was more effective in reducing the tongue induction of potentially malignant and malignant lesions by 4-NQO. A kidney toxicity was observed in healthy animals exposed to 0.1nL/g of TP-4-ol. The negative isoform of terpinen-4-ol negatively modulates the development of potentially malignant and malignant lesions in rats (Rattus nonverdicts albinos, Holtzman) exposed to 4-NQO. (-)-Terpinen-4-ol reduced the mice percentual with squamous cell carcinoma, 87.5 to 41.6%, and decreased the cancer/rat ratio of 2.62 in 4-NQO to 0.75 in 4-NQO + 0.1nL/g. This represents 52.4% by group and 71.3% in the cancer/rat ratio.

Dermoscopy and Reflectance Confocal Microscopy in Actinic Keratosis, Intraepithelial Carcinoma, and Invasive Squamous Cell Carcinoma.

Patients with multiple actinic keratosis (AK), have pre-neosplastic abnormalities, constituting the sites of new tumors, this region is called the cancerization field. Due to the risk of malignant transformation, rigorous evaluation, follow-up, and treatment of the cancerization field is proposed. Recently, non-invasive diagnostic technologies such as confocal reflectance microscopy (RCM), detect AK, intraepithelial carcinomas (IEC), and SCC, without the need of repeated biopsies. There are few reports of the progression of AK assessed by dermatoscopy and RCM concomitantly. Define morphological patterns and clinical applicability of dermatoscopy and MCR examinations of the AK lesions and their degrees of progression to IEC and SCC. A retrospective cross-sectional study of dermatoscopy and RCM examinations was performed in 30 patients with histopathological diagnosis of AK (20), IEC (6), and SCC (4). In the comparative analysis of the dermatoscopic features, erythema was present in 100% of the lesions, the red pseudo-network in 75% of the AK (P=0.007), and linear and irregular vessels in 90% of the lesions of IEC/SCC. In the RCM of AK, the most striking finding was the presence of atypical honeycomb in the spinous layer, but typical in the granular layer. While the IEC/SCC group presented irregular epidermal architecture and atypical honeycomb in all epider-mal layers, it also showed a higher prevalence of individual corneocytes and nucleated cells, cellular pleomorphism, and nuclear atypia in the dermal papillae, irregular vessels within papilla, and cells with bright edges and dark central nuclei in the dermis. Dermoscopy and RCM may be considered as auxiliary methods for assessing lesions resulting from ke-ratinocyte atypia. The results of this study are consistent with published studies and it was possible to propose, with literature support, a model of progression of AK to IEC and SCC. J Drugs Dermatol. 2022;21(3):259-268. doi:10.36849/JDD.5086.

Retromolar trigone squamous cell carcinoma: A population-based analysis of survival

ObjectivesTo evaluate the difference in overall survival (OS) in patients with retromolar trigone squamous cell carcinoma (RMT SCC) treated with surgery alone versus surgery plus postoperative radiotherapy (PORT) versus surgery plus postoperative chemoradiotherapy (POCRT). Materials and MethodsRetrospective cohort study of patients from 1,500 US facilities reporting to the National Cancer Database (NCDB) registry. Participants were adult patients treated with surgery as primary treatment modality for RMT SCC (n = 2,877). Exposures were primary definitive surgery versus surgery + PORT versus surgery + POCRT. Outcomes included OS after diagnosis and treatment of RMT SCC. A multivariate Cox proportional hazards model was constructed to compare survival between the three treatment modalities. Subgroup analysis was performed by T classification and overall staging. ResultsThere were 1,415 (50%) patients treated with surgery alone, 870 (30%) patients treated with surgery + PORT, and 572 (20%) treated with surgery + POCRT. Treatment with surgery + PORT was associated with improved OS compared to surgery alone (relative hazard: 1.25, 95% CI: 1.01, 1.54, p = 0.042). Patients treated with surgery + POCRT also had improved OS compared with surgery alone (relative hazard: 1.89, 95% CI 1.45, 2.43, p < 0.001). Patients with T3/4 tumors had improved OS when treated with surgery + PORT (relative hazard 1.39, 95% CI: 1.05, 1.84, p = 0.022) or surgery + POCRT (relative hazard 2.27, 95% CI: 1.66, 3.15, p < 0.001). Patients with T1 or T2 disease had no significant difference in survival in both the surgery + PORT (p = 0.331) and surgery + POCRT treatment groups (p = 0.134). Therefore, there was no difference in OS for patients with stage I or II disease treated with surgery + PORT (p = 0.451), nor with surgery + POCRT (p = 0.853). ConclusionTreatment with surgery + PORT +/- chemotherapy appears to be associated with significantly improved OS compared to surgery alone for advanced RMT SCCa.

DARS2 to distinguish squamous cell carcinoma from keratoacanthoma Investigation of biomarker properties

Objective: In this study, in the differential diagnosis of squamous cell carcinoma (CHC) and keratoacanthoma (CA) It was aimed to investigate the efficiency of DARS2 protein expression. Methods: A total of 60 cases, consisting of 30 SCC and 30 CA, diagnosed in Fırat University Faculty of Medicine, Department of Pathology, were examined immunohistochemically by studying the DARS2 protein. Results: DARS2 expression values were found to be statistically significant in the differential diagnosis of SCC and CA (p&lt;0.05). Conclusion: The marker we used in our study was found to be useful in the differential diagnosis of SCC and CA, and we believe that further molecular and genetic studies will facilitate the correct diagnosis.