Non-keratinizing Squamous Cell Carcinoma Research Articles

Non-keratinizing squamous cell carcinoma – A rare variant of sinonasal tract malignancy invading orbit: A case report and review of literature

This case report presents a rare case of orbital invasion from non-keratinizing squamous cell carcinoma (NKCa) of paranasal sinuses. A male patient presented with painful bleeding from a mass near the left eye, blood-stained discharge from the left nostril, fatigue, and weight loss. There was a heterogenous lesion inferomedial to the left eye, inside the left nostril, and in the oral cavity. Palpable neck lymph nodes, computed tomography scan showing a bone-eroding lesion, histopathology, and immunohistochemistry findings suggested malignancy of the NKCa variant. Immediate chemotherapy showed improvement after the first cycle, and the patient is under regular follow-up.

Chemotherapy for cervical cancer and contraception: discussion issues and clinical case

Cervical cancer occupies one of the leading places in the structure of oncological diseases of the Female Reproductive System. In the treatment of this pathology, along with the surgical method of treatment, chemotherapy and radiation therapy are used. According to clinical guidelines, in the presence of cervical cancer stages IIB–IIIA, it is allowed to carry out 2–4 cycles of neoadjuvant chemotherapy in order to create conditions for the possibility of performing extended hysterectomy according to Meigs. Pregnancy during chemotherapy is unique and extremely rare.The article presents a clinical case of pregnancy during chemotherapy (performed according to the scheme: taxanes and platinum-containing drugs) in a 27-year-old patient. According to the clinical picture and results of cervical biopsy, the diagnosis was made: invasive nonkeratinizing squamous cell carcinoma of the cervix IIB (cT2bNxM0) G2, right-sided parametric variant, nonspecific (with unspecified HPV status). Taking into account the presence of parametrial infiltration, the age of the patient, the oncological council prescribed from 2 to 4 cycles of chemotherapy according to the TC scheme (paclitaxel, carboplatin) with an interval assessment. After the second cycle of chemotherapy, an early pregnancy was diagnosed – a medical abortion was performed. Against the background of 3 cycles of chemotherapy, the conditions for surgical treatment were formed – surgical treatment was performed in the amount of extended hysterectomy according to Meigs (type III according to Piver/C2 Morrow) with transposition of the ovaries. The postoperative period was uneventful; the patient was discharged in a satisfactory condition.The described case of pregnancy on the background of chemotherapy is of scientific and practical interest, initiating a discussion on the need to counsel such patients regarding reliable contraception, taking into account the eligibility criteria, which will avoid undesirable outcomes during cancer treatment.

Squamous Cell Carcinoma Cervical Uterine Metastasis in Abdominal Wall: A Rare Case Report

ABSTRACTBackground: About 80% of cervical cancers are squamous cell carcinomas. After severe surgery for squamous cervical cancer, abdominal metastasis is an uncommon occurrence.Case Presentation: A 33-year-old lady was diagnosed with cervical cancer and had a radical hysterectomy, bilateral salpingo-oophorectomy, and bilateral pelvic lymphadenectomy. The histopathological examination showed non-keratinizing squamous cell carcinoma moderately differentiated. A 6 cm suggestive metastatic mass from abdominal region came up three months later after the surgery. An abdominal wall reconstruction surgery was conducted as the treatment for the metastasis mass.Conclusion: The best course of treatment for cervical cancer is still unknown due to the rarity of abdominal metastases. Depending on the severity of the illness and the existence of metastases, each patient receives a unique course of treatment.Keywords: squamous cell carcinoma, hysterectomy, cervical malignancies

ANALYSIS OF MORPHOLOGICAL GASTRIC CANCER TYPES

Malignant neoplasms occupy the leading places in the structure of morbidity and mortality of the world's population. Stomach cancer is one of the five most common cancer types in Russia in terms of morbidity and is among the top three in terms of mortality from malignant neoplasms. The aim of the study is to study the morphological gastric cancer types depending on the stage, localization of the tumor process in the stomach and the age of the patient. Materials and methods. A retrospective analysis of data on 412 stomach cancer patients for 2022–2023, examined on the basis of the AI "Republican Clinical Oncology Dispensary" under the Health Ministry of Chuvashia, among whom there were 256 (62.1%) men and 156 (37.9%) women, was carried out. The average age of the patients was 65.6±12 years. All cases have morphological verification. Research results. The most frequently diagnosed morphological types of gastric cancer were identified: adenocarcinoma not otherwise specified (57.3%), colloid cancer (17.2%), less often – gastrointestinal stromal tumor (6.7%) squamous cell non-keratinizing carcinoma (4.1%). The remaining tumor types in gastric cancer were verified less frequently (0.2–3.0%). It was found that the most common morphological types of gastric cancer were detected in most cases in the elderly (over 60 years old) and males. Depending on the tumor localization in the stomach departments, it was verified: if the body of the stomach is affected, almost all types of stomach cancer are observed (the same with affection to the antrum), such types as tubular, micropapillary, neuroendocrine, scyrrhous and mixed were not found in the cardiac department of the stomach. In subtotal and total affection of all stomach parts, the morphological types of gastric cancer corresponded in most cases to not otherwise specified adenocarcinoma and colloid carcinoma. Such morphological type of gastric cancer as not otherwise specified adenocarcinoma which made up the bulk of all types of malignant gastric cancers, was mainly (in 52.1%) detected at stages III and IV of the disease and only in 16.9% of patients – at the early I stage of the disease. Other morphological types of gastric cancer identified in the late stages of the tumor process included colloid carcinoma, non-keratinizing squamous cell carcinoma and carcinoma simplex. Conclusions. The analysis of morphological gastric cancer types the predominance of adenocarcinomas and colloid cancer, identified more often in the late stages of the tumor process. The predominant localization of various morphological types of gastric cancer with body damage was established. The most common morphological types of gastric cancer are found in the elderly, more often in men.

CLINICOPATHOLOGICALCHARACTERISTICS OF NASOPHARYNGEALCARCINOMA AT CENTRAL GENERAL HOSPITAL PROF. DR. I.G.N.G. NGOERAH DENPASAR IN 2021-2022

ABSTRACT
 
 Nasopharyngeal carcinoma (NPC) epidemiologically occupies the fourth position as the highest number of malignancy cases in Bali, Indonesia. The most common histological type of NPC cases are non-keratinizing squamous cell carcinoma (NKSCC) undifferentiated subtype. This research aims to know the clinicopathological aspect of nasopharyngeal carcinoma at Central General Hospital Prof. Dr. I.G.N.G Ngoerah Denpasar in 2021-2022 regarding the distribution of age range, gender, education, occupation, clinical stage, histological type, as well as the results of anamnesis. The research design is a descriptive study of 70 cases of NPC at Central General Hospital Prof. Dr. I.G.N.G Ngoerah Denpasar from 2021 to 2022. Samples were collected retrospectively from secondary data using a total sampling technique through a cross-sectional study, samples were obtained from medical record data and hospital management system of Central General Hospital Prof. Dr. I.G.N.G Ngoerah Denpasar. In this study, the most cases of NPC were found in the range of 51-60 years old (32.9%), male sex (65.7%), high school education status (48.6%), private employee employment (32.9%), anamnesis results of a lump in the neck (77.1%), stage IVA (40%), and with the histological type of NKSCC undifferentiated subtype (90%). Men have twice the risk of suffering from NPC compared to women, most cases have complained of a lump in the neck and other symptoms such as nasal congestion, tinnitus, headaches. The most common histological type found is the NKSCC undifferentiated subtype, which mostly occurs in advanced stages of an IVA.
 Keywords : Clinicopathology, NPC, Nasopharynx

The role of radiation therapy in the treatment of early-stage skin cancer

Introduction. Radiation therapy remains one of the main methods of radical treatment of early-stage skin cancer. Its position in combination and comprehensive treatment has changed significantly as improvements of radiotherapy techniques and introduction of modern technologies led to increased effectiveness and comfort of the method and allowed to achieve better prognostic outcomes.Aim. To evaluate the role of radiotherapy in treatment of patients with early-stage skin cancer (T1–2N0M0).Materials and methods. A retrospective and prospective analyses of data from 1049 patients with early-stage skin cancer were performed. In 527 (50.23 %) cases, the tumor was localized mainly on the head and neck: 48 % of patients had nonkeratinizing squamous cell carcinoma of the skin, 7.59 % of patients had keratinizing squamous cell carcinoma, 44.41 % of patients had basal cell carcinoma.Results. Data from 527 patients (51.04 % man and 48.96 % women) with early-stage skin cancer (T1–2N0M0) who received treatment and are registered at the Republican Oncological Scientific Center of the Ministry of Health and Social Protection of the Tajikistan Republic were analyzed. The disease was more common in patients aged between 60 and 90 years. The main factor in stage determination was tumor size in accordance with the Tumor, Nodus and Metastasis (TNM) classification. In 240 (46.54 %) patients, the size of primary tumor was less than 2 cm in the largest diameter (T1N0M0), in 287 (54.46 %) patients its maximal size was between 2 and 4 cm (T2N0M0). Selection of treatment method was mainly based on morphological characteristics and location of the tumor. In 121 (50.42 %) patients with skin cancer T1N0M0, radiation therapy was performed as monotherapy in a radical program; in 88 (36.37 %) patients in combination with cobalt therapy and surgery; in 23 (9.59%) patients in combination with cobalt therapy, polychemotherapy and surgery; in 8 (3.41%) patients in combination with cobalt therapy and polychemotherapy.The capabilities of radiation therapy both as monotherapy and in combination with other treatment methods before and after surgical treatment present ample opportunities for clinicians to achieve good outcomes. The use of radiation therapy as monotherapy in a radical program in patients with T1N0M0 stage skin cancer is effective in 96.4 % of cases, in patients with stage T2N0M0 the effectiveness can reach 91.2 %.Conclusion. Radiation therapy can be successfully used in treatment of early-stage skin cancer along with other methods. Its use both independently and as part of combination and comprehensive therapy allows to achieve reliable treatment outcomes. Adequate selection of radiation therapy option in treatment of early-stage skin cancer is the key to longterm clinical remission and improvement of patients’ quality life.

Primary squamous cell carcinoma of the parotid salivary gland: a clinical observation

Introduction. Malignant tumors of the salivary glands account for 3–5 % of all cases of head and neck cancer. Squamous cell carcinoma is the rarest histological variant of this pathology. It accounts for an average of 1.6 %. Among large salivary gland tumors, squamous cell carcinoma most often occurs in the parotid salivary gland.Aim. To present a clinical case of primary disseminated cancer of the parotid salivary gland with squamous cell structure.Clinical observation. A 70-year-old patient was under observation who was diagnosed with a primary squamous cell tumor of the parotid salivary gland with multiple metastases during a complex examination. He was sick for about 6 months when asymmetry of left half of the face appeared due to a painful neoplasm in the parotid salivary gland. Recently, the patient has noted increased tumor growth. Objective examination revealed peripheral paralysis of the facial nerve on the left. In the parotid-masticatory region on the left, with a transition to the zygomatic region, there is a dense painful immobile exophytic tumor with infiltration into soft tissues of the face and skin 6.5 × 5.0 cm in size with an ulcer in the center. Laterally, it reaches the tragus, and at the bottom-the angle of the lower jaw. In the submandibular region on the left, metastatic lymph nodes 2.5 × 2.0 cm in size are palpated. A biopsy was collected. Histological conclusion: non-keratinizing squamous cell carcinoma. Expression of the programmed death receptor ligand (PD-L1) in the tumor is negative. Mutations of genes Her2-neu and BRAF were not detected. According to medical imaging methods, multiple metastases were found in the lungs, liver, zygomatic bone and tumor growth in the maxillary sinus on the left. The diagnosis was established: cancer of the parotid salivary gland, stage IVC, cT4N1M1, with metastases to the liver, lungs and bones. Polychemotherapy was prescribed according to the scheme: 5-fluorouracil + cisplatin + cetuximab + bisphosphonates. After 3 cycles, a partial regression is obtained.Conclusion. The primary squamous cell carcinoma is prone to an aggressive course and has an unfavorable prognosis, especially in patients over 60 years of age with skin and facial nerve damage, as well as the presence of regional and distant metastases. Differential diagnosis is necessary to exclude the secondary nature of the tumor. The presented case is a rare example of primary squamous cell carcinoma of the parotid salivary gland with extensive metastatic lesion and regression of the pathological process after polychemotherapy in combination with targeted therapy.

Rare non-serous fallopian tube cancers: institutional experience and literature review.

We reviewed 63reports from the literature on rare non-serous tumors of the fallopian tubes and carried out acomparative analysis of clinical manifestations and diagnostic methods. We also report our observations from patients with these tumors. Of 157 patients with primary fallopian tube cancer (FTC) treated in our regional oncological hospital between 1970 and 2020, there were nine (6%) cases of rare non-serous cancers, including one case each of choriocarcinoma, carcinosarcoma, and neuroendocrine tumor, and two cases each of non-keratinizing squamous cell carcinoma, mucinous adenocarcinoma, and clear cell adenocarcinoma. For carcinosarcoma and squamous cell, clear cell, and transitional cell carcinomas, clinical history, patient age, and clinical manifestations were similar to the main group of FTCs. Choriocarcinoma differed significantly from other cancers of the fallopian tubes in terms of patient age and clinical course. Mucinous adenocarcinoma, mesothelioma, and borderline tumors, with rare exceptions, were almost always asymptomatic and were found only incidentally during surgery. Choriocarcinoma and carcinosarcoma had an aggressive course, while squamous cell, transitional cell, clear cell, and mucinous carcinomas were less aggressive. Since most rare non-serous tumors have asimilar disease course to typical FTCs and there is alack of appropriate treatment protocols for rare tumors, treatment options developed for ovarian tumors and FTC are justified for these tumors. Rare non-serous malignant fallopian tube tumors are very similar to serous and endometrioid FTC in terms of clinical manifestations and diagnosis.

Transplantation of mitochondria from human malignant tumor cells as a method of tumor growth formation in the lungs of laboratory animals

Purpose of the study. Obtaining lung cancer tumors in Balb/c Nude mice by transplantation of mitochondria isolated from human malignant tumors.Materials and methods. Human lung cancer mitochondria were isolated using differential centrifugation on a high-speed refrigerated centrifuge. Mitochondrial samples were diluted with 0.9 % NaCl solution to a protein concentration of 3 mg per animal. Freshly isolated lung cancer mitochondria were once transplanted into the tail vein of male Balb/c Nude mice (n = 6) at the rate of 3 mg of protein per 1 animal in 0.4 ml of saline. Male mice of Balb/c Nude line (n = 4), which were injected with 0.4 ml of physiological solution into the tail vein once a day, served as a control group. All animals were killed by guillotine decapitation 4 months after intravenous transplantation of mitochondria isolated from lung cancer.Results. After the introduction of mitochondria into the tail vein of mice, no changes were found in the animals’ behavior, coloration of coverings. No respiratory problems, and no allergic reactions to the introduction of foreign protein were detected. Respiratory problems in mice with mitochondrial transplantation occurred between days 113 and 123, when a drop in body weight ≥ 25 % was observed. A uniform formation of tumor nodes together with an active filling of the lung space with blood was clearly visible on lung preparations of a Balb/c Nude male mouse after intravenous transplantation of mitochondria from the lung of a patient with non-keratinizing squamous cell carcinoma. Similar characteristics of tumor growth in the lung parenchyma of the patient and Balb/c Nude mice as direct recipients of tumor mitochondria involved solid structures consisting of fields, cells and strands of tightly fitting atypical polymorphic cells of the squamous epithelium with poorly developed cytoplasm. In addition, signs of adenocarcinoma included glandular and papillary-like structures and cell complexes with large nucleoli. Squamous epithelial cells were characterized by severe atypia and polymorphism. The shape of the nuclei was irregular in most cells, with large sizes, the color was heterogeneous, and the nucleoli were enlarged. Multinucleated cells, as well as pathological mitoses with clearly marked division figures, which testified to their proliferative activity, were encountered with a rather high frequency.Conclusions. Application of intravenous transplantation of mitochondria isolated from malignant human lung tumor in male mice of Balb/c Nude line causes growth and development of malignant foci in male Balb/c Nude mice. This is previously unknown fact in experimental oncology, allowing the study of new properties of mitochondria of human cancer cells.

Primary DEK::AFF2 fusion positive nonkeratinizing squamous cell carcinoma of the middle ear: report of a case

Primary DEK::AFF2 fusion positive nonkeratinizing squamous cell carcinoma of the middle ear: report of a case

HPV-Associated Squamous Cell Carcinoma of the Eyelid: Diagnostic Utility of p16 Immunohistochemistry and mRNA In Situ Hybridization.

High-risk (HR) Human papillomavirus (HPV) has been implicated in pathogenesis of squamous cell carcinomas (SCC) at several sites with mucocutaneous junctions, including the head and neck. SCC is the second most common eyelid malignancy. However, its association with transcriptionally active HR-HPV has not been adequately studied. Two index cases of eyelid HPV-associated SCC are described in detail. A retrospective cohort of eyelid SCC was examined for p16 immunoexpression. Cases demonstrating p16 positivity or equivocal staining were subjected to high-risk HPV mRNA in situ hybridization (ISH). Quantitative real-time PCR (qPCR) was performed in mRNA ISH-positive cases for HPV genotyping. The two index patients were older adult females, with upper eyelid tumours. On histology, both tumours were non-keratinizing SCC with trabecular and nested architecture reminiscent of oropharyngeal HPV-associated non-keratinizing SCC, prompting p16 immunohistochemistry, which was positive. HR-HPV mRNA ISH was positive, and qPCR detected HPV16 in both cases. Three of 20 (15%) archival cases showed p16 immunopositivity and two (10%) showed equivocal staining. However, mRNA ISH was negative. All cases showing p16 immunostaining and lacking HR-HPV were keratinizing SCCs. Thus, 9% of all eyelid SCC examined demonstrated HR-HPV. The prevalence of HR-HPV in eyelid SCC is low in Indian patients. HPV-associated SCC may mimic commoner eyelid carcinomas as it lacks overt keratinization. In basaloid-appearing eyelid carcinomas, p16 immunopositivity should be followed by reflex HR-HPV mRNA ISH, as p16 immunohistochemistry alone has low specificity. The prognostic role, if any, of HPV association needs further evaluation.

Update from the 5th Edition of the WHO Classification of Nasal, Paranasal, and Skull Base Tumors: Imaging Overview with Histopathologic and Genetic Correlation.

Sinonasal and skull base tumors are a heterogeneous group of neoplasms with considerable histologic variation and overlapping imaging features. In 2022, the World Health Organization updated the head and neck tumor classification, further emphasizing the importance of molecular data and genetic alterations in sinonasal neoplasms. The changes include the addition of new entities and discussion of emerging entities, as well as changes to the taxonomy and characterization of tumors. The new classification focuses on entities that develop in these sites either exclusively (eg, olfactory neuroblastoma) or most frequently. Another change includes reduction in the number of categories by creating separate category-specific chapters for soft-tissue, hematolymphoid, and neuroectodermal lesions. In this review, we briefly discuss the various categories in the new classification with a more detailed description of the 2 new entities (SWItch/Sucrose Non-Fermentable complex-deficient sinonasal carcinomas and human papillomavirus-related multiphenotypic sinonasal carcinoma). We also highlight the emerging entities including IDH-mutant sinonasal malignancies and DEK-AFF2 carcinoma, presently classified as sinonasal undifferentiated carcinoma and nonkeratinizing squamous cell carcinoma, respectively.

Clinicopathological Parameters and Biomarker Profile in a Cohort of Patients With Head and Neck Squamous Cell Carcinoma (HNSCC).

Squamous cell carcinoma (SCC) is the most common malignancy of the head and neck region, commonly termed as head and neck squamous cell carcinoma (HNSCC).Data related to biomarker expression in HNSCC are scarcely available, especially in our population. This study aimed to evaluate the association of immunohistochemical (IHC) expression of p16, epidermal growth factor receptor (EGFR), p27, and p53 in HNSCC with clinical and pathological parameters. This retrospective cross-sectional study was conducted at the Department of Histopathology, Liaquat National Hospital, Karachi, Pakistan from February 2017 to January 2022. A total of 308 cases of HNSCC with upfront surgical resection were included in the study. IHC analysis was performed for EGFR, p16, p27, and p53, and association with clinicopathological parameters was sought. p16, EGFR, and p53 positivity were noted in 22.1%, 18.8%, and 66.2% cases, respectively, whereas loss of p27 expression was seen in 14.3% cases of HNSCC. A significant association of p16 expression was observed with age, tumor size, tumor site, nodal metastasis, extranodal extension (ENE), and perineural invasion (PNI). Cases aged over 50 years were more significantly associated with positive p16. Similarly, cases with oral cavity SCC were more significantly associated with positive p16. HNSCC with larger tumor size, the presence of nodal metastasis, and ENE and PNI were associated with negative p16 expression. Similarly, a significant association of EGFR expression was observed with age, tumor size, tumor site, histological subtype, histological differentiation, nodal metastasis, ENE, and PNI (p < 0.05). Cases of HNSCC with age less than 50 years were associated with positive EGFR expression. Similarly, oral cavity and lip SCCs were associated with positive EGFR expression compared with other sites. Moreover, positive EGFR expression was significantly associated with nodal metastasis, ENE, moderate histological differentiation, and the presence of PNI. Loss of p27 expression was significantly associated with nodal stage and ENE; low nodal stage and absence of ENE were associated with p27 loss of expression, whereas no significant association was seen with other pathological parameters. Alternatively, a significant association of mutant-type p53 expression was noted with gender, nodal stage, and histological subtype. Females with HNSCC show a higher frequency of mutant-type p53 expression than males. Moreover, higher nodal stage (N2b and higher) and non-keratinizing SCCs were significantly associated with mutant-type p53 expression. Our study found a high expression of EGFR and mutant-type p53 expression in HNSCC. Conversely, p16 expression and loss of p27 expression were low. Moreover, EGFR and mutant-type p53 expression were associated with poor pathological parameters, whereas p16 expression was associated with better histological features.

Lumbar metastases in nasopharyngeal carcinoma (NPC) patient with uncomplete chemoradiation

Nasopharyngeal carcinoma (NPC) is a tumor arising from the epithelial cells that cover the surface and line the nasopharynx. In Indonesia, NPC is the 4th most prevalent. Nasopharyngeal Carcinoma stage IVB as distant metastasis. The therapy in nasopharyngeal carcinoma (NPC) is Chemoradiotherapy. Concurrent chemoradiotherapy is either an established treatment modality or actively being investigated. Chemoradiotherapy have demonstrated decreased incidence of distant metastases compared with radiation only, however only if its treatment done completely. Here we present a rare case of unfinished chemoradiotherapy that caused metastases nasopharyngeal carcinoma patient. A 41-years-old consulted to ENT-HN department with main complaints of progressive cancer pain for 3 month and got worse in past 1 month. Patient also complaints for the pain at the waist, chest and headache currently. However, there was formal history of nasopharyngeal carcinoma for this patient since 2019 that had been treated with 3 cycles of chemotherapy and 26 cycles of radiotherapy. The patient was diagnosed with recurrent nasopharyngeal carcinoma post chemotherapy and radiotherapy with metastatic process. Unfortunately, the treatment underwent was not complete. A nasopharyngeal biopsy was performed and the histopathology result revealed a non-keratinizing squamous cell carcinoma nasopharynx. Lumbar CT-scan showed distant metastatic to lumbar vertebrae I-V. Nasopharyngeal carcinoma (NPC) represents a rare disease that showed as carcinoma that appears in the nasopharynx. The unfinished treatment of NPC leads to recurrent NPC and metastatic process to lumbar vertebrae I-V. Nevertheless, 20% of patients are radioresistant and experience a recurrence, which in most cases manifests with distant metastases.

Sinonasal DEK-rearranged Papillary Non-keratinizing Squamous Cell Carcinoma: Expanding the Emerging Entity.

The newly emerging sinonasal carcinomas have demonstrated diverse morphologies and specific molecular mutations along with deviant clinical behavior from conventional counterparts. Also, many sinonasal malignancies turned to be SMARCB1/SMARCA4-deficient. Even with the morphological similarities between poorly differentiated (non) keratinizing sinonasal squamous cell carcinoma (SNSCC) from DEK::AFF2 SNSCC, the two lesions are not distinguishable using the surrogate immunohistochemical marker AFF2 or molecular testing for DEK::AFF2 mutation. We report a rare case of SMARCB1-retained DEK-rearranged papillary non-keratinizing SNSCC in a 53-year-old female, who presented with a polypoid mass corresponding to the left middle turbinate. The tumor and locoregional lymph nodes were surgically resected, followed by adjuvant radiotherapy.

Sinonasal neoplasms: Update from the WHO 2022

The pathology of poorly differentiated sinonasal malignancies has undergone adynamic evolution during the last decade, resulting in arefined, mostly genetically or etiologically oriented classification of neoplasms in the historical spectrum of sinonasal undifferentiated carcinoma (NUT carcinoma, SWI-/SNF-deficient carcinomas, and others). Moreover, some new entities have been established, while others could be further delineated and better characterized. Ahighlight of the new classification is the inclusion of SWI/SNF (SMARCB1 or SMARCA4)-deficient carcinomas into aseparate category. In addition, carcinomas with DEK::AFF2 fusions have been included as aprovisional entity in the spectrum of nonkeratinizing squamous cell carcinoma. This review addresses the major changes in the classification of sinonasal tract neoplasms in the new WHO classification.

Treatment trends and prognostic factors related to histology of squamous cell carcinoma of the prostate: A SEER review.

e17120 Background: Excluding skin cancers, prostate cancer is the most common malignancy in males. Over 93% of prostate cancers are adenocarcinomas, and as such, an abundance of literature exists with regards to its screening, treatment, and prognosis. Often overlooked, however, data is lacking with regards to squamous cell carcinoma (SCC) of the prostate, a rare alternative form of prostatic cancer comprising fewer than 1% of malignancies. Given the rarity of SCC of the prostate there are neither accepted treatment guidelines nor consistent characterizations of the disease’s histogenesis and histopathology. This study seeks to improve existing guidelines on the treatment of prostate SCC by supplementing current literature with a novel method of longitudinal data collection in the form of the SEER database. Methods: This was a retrospective cohort study utilizing the Surveillance, Epidemiology and End Results (SEER) database sponsored by the National Cancer Institute (NCI). Investigated variables entailed patient demographics such as race and age, tumor characteristics including grade, tumor type, and histopathologic characteristics. Treatment modalities (surgical resection, radiation therapy, and systemic therapy) as well as disease characteristics were considered in generating Kaplan Meier overall survival (OS) curves compared using log rank test. Results: The most abundantly utilized treatment was surgery (58.6%), either alone or in conjunction with systemic and radiotherapy. Surgery alone was utilized for 24 patients and chemotherapy alone was utilized for 7 patients. Interestingly, only 14% of patients received multimodality treatment. Prostatic squamous cell carcinoma was the ultimate cause of death in 63.8% of cases. Kaplan Meier analysis demonstrated a median OS of 13 months. When stratifying by histopathologic characteristics, our results showed a significant difference in overall survival between patients with papillary carcinoma, with the median survival time of four years, and non-keratinizing squamous cell carcinoma, with a median survival time of one year (p = 0.005). Conclusions: Further studies are warranted regarding this exceedingly rare and understudied malignancy. The current analysis suggests subclassification of SSC of the prostate into papillary versus non-keratinizing squamous cell carcinoma may yield valuable prognostic information. Further research may emphasize this distinction as well as the role of multimodal treatment which appears to be underrepresented in SSC of the prostate when compared to other similar malignancies.

Bilateral infiltrative kidney metastasis due to non-keratinizing squamous cell carcinoma of the lung: lesson for the clinical nephrologist.

Bilateral infiltrative kidney metastasis due to non-keratinizing squamous cell carcinoma of the lung: lesson for the clinical nephrologist.

Clinicopathologic features, tumor immune microenvironment and genomic landscape of EBV-related and EBV-unrelated poorly differentiated nonkeratinizing squamous cell carcinoma of the thymus

ObjectivesKnowledge regarding thymic EBV-related poorly differentiated nonkeratinizing squamous cell carcinoma (PDNKSCC), also known as lymphoepithelial carcinoma (LEC), is extremely limited due to its rarity. Materials and MethodsThis multi-institutional study enrolled 85 patients with thymic PDNKSCC. DNA in situ hybridization was performed to evaluate the EBV status of all 85 cases. Immunohistochemistry and next generation sequencing were performed to compare the differences in the clinicopathological and molecular features between EBV-related and EBV-unrelated PDNKSCC. Tumor-infiltrating lymphocytes (TILs) were also analyzed by these methods. ResultsThe 85 cases were classified into 27 EBV-related PDNKSCCs (31.8 %) and 58 EBV-unrelated PDNKSCCs (68.2 %) according to the EBV status, and 35 Lymphoepithelioma pattern (LP) (41.2 %) and 50 desmoplastic pattern (DP) (58.8 %) according to the histological characteristics. Compared to the EBV-unrelated PDNKSCC, EBV-related PDNKSCC showed a younger patient predominance and more commonly displayed a LP subtype. Additionally, LP-type cases were divided into two groups: Group 1 (EBV-related, 20/85) and Group 2 (EBV-unrelated, 15/85); the DP-type cases were divided into Group 3 (EBV-unrelated, 43/85) and Group 4 (EBV-related, 7/85). The four Groups showed a significant association with patients’ OS and PFS. EBV-related PDNKSCC had significantly higher PD-L1 + tumor cells (TCs) and PD-L1 + and CD8 + immune cells (ICs) than EBV-unrelated PDNKSCC. The tumor microenvironment immune type (TMIT) I (PDL1-Tumor+/CD8-High) was more common in EBV-related PDNKSCC, especially in Group 1(LP and EBV related) with more than 90 % cases belonged to TMIT I. Molecular analysis demonstrated that EBV-related PDNKSCC had a significantly higher tumour mutational burden and frequency of somatic mutations than EBV-unrelated cases. ConclusionsEBV-related PDNKSCC, especially the Group 1, could be a candidate for immunotherapy and EBV positivity may provide an indication for the selection of targeted therapy due to their high tumour mutational burden.

Spatial genomic diversity associated with APOBEC mutagenesis in squamous cell carcinoma arising from ovarian teratoma.

Although the gross and microscopic features of squamous cell carcinoma arising from ovarian mature cystic teratoma (MCT-SCC) vary from case to case, the spatial spreading of genomic alterations within the tumor remains unclear. To clarify the spatial genomic diversity in MCT-SCCs, we performed whole-exome sequencing by collecting 16 samples from histologically different parts of two MCT-SCCs. Both cases showed histological diversity within the tumors (case 1: nonkeratinizing and keratinizing SCC and case 2: nonkeratinizing SCC and anaplastic carcinoma) and had different somatic mutation profiles by histological findings. Mutation signature analysis revealed a significantly enriched apolipoprotein B mRNA editing enzyme catalytic subunit (APOBEC) signature at all sites. Intriguingly, the spread of genomic alterations within the tumor and the clonal evolution patterns from nonmalignant epithelium to cancer sites differed between cases. TP53 mutation and copy number alterations were widespread at all sites, including the nonmalignant epithelium, in case 1. Keratinizing and nonkeratinizing SCCs were differentiated by the occurrence of unique somatic mutations from a common ancestral clone. In contrast, the nonmalignant epithelium showed almost no somatic mutations in case 2. TP53 mutation and the copy number alteration similarities were observed only in nonkeratinizing SCC samples. Nonkeratinizing SCC and anaplastic carcinoma shared almost no somatic mutations, suggesting that each locally and independently arose in the MCT. We demonstrated that two MCT-SCCs with different histologic findings were highly heterogeneous tumors with clearly different clones associated with APOBEC-mediated mutagenesis, suggesting the importance of evaluating intratumor histological and genetic heterogeneity among multiple sites of MCT-SCC.