Non-invasive Squamous Cell Carcinoma Research Articles

Cutaneous squamous cell carcinoma of the lip successfully treated with rhenium-188 brachytherapy.

Cutaneous squamous cell carcinoma (SCC) is the second most common form of skin cancer. In most cases, non-invasive SCC has a good prognosis and is curable by surgical resection. Nevertheless, a small percentage of patients pose specific management problems due to the technical difficulty of maintaining function and aesthetics because of the size or location of the tumor. An emerging therapeutic approach with high-dose brachytherapy using a nonsealed rhenium-188 resin, commercially known as Rhenium-Skin Cancer Therapy®, has been shown to be highly effective in non-invasive carcinoma, up to a thickness of 2-3 mm.

Modern view on epidermal dysplasia carcinogenesis.

We analyzed 85skin bioptates of patients with epidermal dysplasia of the skin (Gr 1- 43patients with actinic keratosis; Gr 2- 21patients with non-invasive squamous cell carcinoma of the skin; Gr 3- 21patients with invasive squamous cell carcinoma of the skin) by molecular genetic testing of gene polymorphisms: TP53 (G13494A), L-myc (T3109G), TNF-α (G308A) in tumor tissue. The histological examination revealed the levels of dysplasia of the epidermis. In case of the same disease duration in patients of Gr1/Gr3, L-myc (3109TT) is a genetic component of malignant transformation of epithelial skin cells (p = 0.004) and the development of invasive squamous cell carcinoma. Other variants of 3109TG and 3109GG genes do not have such prognostic value for the risk of skin cancer compared to 3109TT. Significant differences were found in the distribution of (13494GA) when comparing Gr 1with Gr 3 (p = 0.014) and Gr 2with Gr 3 (p = 0.038). A significant increase in the distribution of 13494GA genotype was revealed in patients with invasive form of keratinocyte intraepidermal neoplasia. 13494A allele was more likely to be detected in patients of Gr 3compared to Gr 2 (p = 0.030) that proves the association of this allele with the development of invasive malignancies of the skin. The association of 308GG genotype and TNF-α (308G) allele with the development of malignant skin lesions was found. Comparing the distribution of 308G allele in patients of Gr 1and Gr 2, we found its significant increase in patients of Gr 1. Comparative analysis of gene polymorphism with tumor invasion level showed a significant difference only in 308GG genotype between patients with grade III of KIN (keratinocyte intraepidermal neoplasia) in Gr 2and patients with KIN III of Gr 1 (p = 0.007), and 308GA between patients with KIN III of Gr 2and KIN III of Gr 1 (p = 0.027). Our work has supplemented modern vision of genetic component in pathogenetic mechanism of the development of epidermal dysplasia of the skin. Thus, the association of L-myc (3109TT) with the development of malignant skin lesions of different invasiveness and the modifying effect of TNF-α (G308A) and TP53 (G13494A) gene variants on pathological transformation in the focus of EDS depending on the level of epithelial dysplasia was revealed.

A unique case of esophageal carcinosarcoma with histopathological diversities

We report a 57-year-old Japanese male with esophageal carcinosarcoma with histopathological diversities. The patient complained of dysphagia. Endoscopy of the upper gastrointestinal tract revealed a mass in the lower esophagus just above the esophagogastric junction. Pathological diagnosis of the biopsy was poorly differentiated squamous cell carcinoma/undifferentiated carcinoma. Preoperative chemotherapy was performed with poor response. Post-operative analyses revealed that the chest CT showed the appearance of mineralization after neoadjuvant chemotherapy. Surgery revealed a mass in the lower esophagus invading the esophagogastric junction from above. The mass was macroscopically polypoid with an infiltrative ulcer. The pathological diagnosis of the surgical specimen was carcinosarcoma of the lower esophagus, composed of sarcomatoid components (undifferentiated pleomorphic sarcoma-like, osteosarcomatous and chondrosarcomatous), invasive adenocarcinoma with ductal and glandular differentiation, several foci of non-invasive squamous cell carcinoma and invasive conventional and basaloid squamous cell carcinoma (ypT3N0M0, stage II). One year after the operation, the left hilar lymph node enlarged. A biopsy of the lymph node showed adenocarcinoma, consistent with metastatic esophageal cancer. Additional chemotherapy was given. Two years and four months after the operation, the patient died of multiple metastases, these included the brain.

Genital Bowen's Disease in a Bulgarian Patient: Complete Remission after Surgical Approach.

A 60-year-old male patient presented with complaints of persistent red to a brown-colored plaque on his scrotum, with duration of approximately three years. The patient had been treated with oral and topical antifungals for inguinal tinea for several months and after that with topical corticosteroids for eczema for several more months. None of the regimens achieved any therapeutic effect. The histopathological evaluation revealed the presence of atypical keratinocytes in all layers of the epidermis with the altered epidermal pattern, spread parabasal mitotic activity, without secondary satellites, multiple dyskeratotic cells and multinucleated cells. The diagnosis of an intraepithelial non-invasive squamous cell carcinoma, associated with koilocytic dysplasia and hyperplasia was made, meeting the criteria for Bowen disease. An elliptic surgical excision of the lesion was made, while the defect was closed with single stitches, with excellent therapeutic and aesthetic result. First described by John T. Bowen in 1912, Bowen disease (BD) represents a squamous cell carcinoma (SCC) in situ with the potential for significant lateral spread. Treatment options include the application of topical 5-flurorouracil cream – useful in non-hairy areas, imiquimod cream or destructive methods such as radiation, curettage, cryotherapy, laser ablation and photodynamic therapy, especially useful in nail bed involvement. Despite the early lesions, surgical excision is the preferred treatment option, regarding the potential malignant transformation risk.

Malignant transformation of exophytic Schneiderian papilloma of the nasal cavity

Schneiderian papilloma (SP) is classified into three types: inverted, oncocytic, and exophytic. Malignant transformation occurs in 10% of SP; most are inverted and oncocytic types. Malignant transformation of polypoid exophytic SP is exceptional; only two cases have been reported in the English literature. A 58-year-old man consulted our hospital because of nasal obstruction. Nasal endoscopy and imaging modalities showed a polyp in the right nasal cavity. Biopsy findings showed compatibility with SP. However, since fludeoxyglucose positron emission tomography (FDG-PET) showed signals, polypectomy was performed. Grossly, the polyp was reddish white and measured 2 cm. Histologically, the polyp consisted of a non-invasive squamous cell carcinoma (SCC) component (70%), a mature squamous component (20%), and Schneiderian epithelium (10%). Vague koilocytosis was present in the SCC component. The three components were arranged in an exophytic papillary pattern. Immunohistochemically, the non-invasive SCC component was positive for cytokeratins (AE1/3, CAM5.2, CK5/6), p63, p53, and Ki67 (labeling 50%). The mature squamous component was positive for cytokeratins (AE1/3, CAM5.2 and CK5/6), p63, and Ki67 (labeling 6%). The Schneiderian component was positive for cytokeratins (AE1/3, CAM5.2, and CK5/6), p63, and Ki-67 (labeling 4%). The tumor was HPV negative in the three components. The polyp was diagnosed as exophytic Schneiderian carcinoma arising from exophytic SP. The patient is now free from tumor 4 years after the operation.

Invasive Cutaneous Squamous Cell Carcinoma Presenting as a Nonhealing Radiation Wound

Cutaneous squamous cell carcinoma is the second most common form of skin cancer and accounts for 20% of cutaneous malignancies. We report the case of a patient who presented with a complaint of nonhealing wounds following radiation therapy for the treatment of noninvasive squamous cell carcinoma of both lower extremities. Initial biopsies of the wounds were benign. However, a second biopsy performed approximately 2 months later was found to be positive for invasive squamous cell carcinoma. This case uniquely exemplifies that all nonhealing wounds should be viewed with a critical eye for possible malignancy even in the presence of previous negative biopsy. This is especially true for radiation wounds that may be prone to malignant transformation or recurrence.

Pediatric vulvar squamous cell carcinoma in a liver transplantation recipient: a case report

Here we report the first Korean case of a girl who developed noninvasive squamous cell carcinoma of the vulva at the age of 16 years. She was taking tacrolimus, an immunosuppressive agent, after living-related liver transplantation. The vulvar masses were microscopically proved as vulvar intraepithelial neoplasm II and III, even squamous cell carcinoma in situ. Human papillomavirus subtypes (69 and 73) and human papillomavirus types (66, 70, 73, and 43) were detected in the vulvar mass and the cervicovaginal smear, respectively. The outcome of liver transplantation for children has been markedly improved during the last several decades. However, the present case highlights the need to perform periodic genital examinations for the adolescents after liver transplantation. In addition to the high risk and probable high subtypes, uncommonly found human papillomavirus subtypes were extracted from her vulvar cancer. The present case is the first to show the possible relationship between previously unknown and uncommon human papillomavirus subtypes and pediatric post-transplant vulvar squamous cell carcinoma. More attention should be paid to the vulvar and cervical surveillance of pediatric transplant recipients by both medical specialists and general physicians.