Papillary Squamous Cell Carcinoma Research Articles

Papillary squamous cell carcinoma: retrospective analysis of 41 cases

Papillary squamous cell carcinoma: retrospective analysis of 41 cases

Comparison Between p16INK4A Immunohistochemistry and Human Papillomavirus Polymerase Chain Reaction Assay in Oral Papillary Squamous Cell Carcinoma

Oral papillary squamous cell carcinoma (OPSCC) is a histologic variant of SCC with a growth pattern suggesting human papillomavirus (HPV) infection. The aim of this study was to investigate the presence of HPV genotypes in OPSCC. All cases with a histologic diagnosis of OPSCC from 1993 through 2008 were retrieved and confirmed. Immunohistochemical evaluation for the surrogate marker p16(INK4A) and HPV polymerase chain reaction were performed in tissue and DNA derived from formalin-fixed paraffin-embedded tissue. Forty-four patients with confirmed OPSCC (mean age, 71.96 yr; female-to-male ratio, 1.75:1) comprised the study population. The most common site of involvement was the gingiva followed by the palate and buccal mucosa. Forty cases exhibited an invasive component, 1 was noninvasive, and in 3 cases invasion could not be confirmed owing to suboptimal thickness of the biopsy. Paraffin tissue blocks were available in 41 cases. Twenty-three cases (56.1%) exhibited positive p16(INK4A) staining, which was primarily weak to moderate with a generally focal pattern. Polymerase chain reaction assays were negative for HPV DNA in all cases. In this study, there was a clinical predilection of OPSCC in older women, with most cases occurring in the masticatory mucosa. Weak to moderate and focal p16(INK4A) staining was appreciated in contrast to reported staining properties in genital and oropharyngeal PSCC. Failure of the polymerase chain reaction assay to exhibit transcriptionally active HPV genotypes suggests that HPV is not associated with OPSCC tumorigenesis.

Papillary Variant of Squamous Cell Carcinoma Arising on the Gingiva: 61 Cases Reported from Within a Larger Series of Gingival Squamous Cell Carcinoma

Papillary squamous cell carcinoma (PSCCA) is a rarely occurring variant of squamous cell carcinoma (SCCA) with distinctive exophytic and papillary features and a more favorable prognosis than conventional SCCA. The larynx is the most commonly affected site in the head and neck. The oral cavity, oropharynx, sinonasal tract, and nasopharynx are also affected. Within the oral cavity cases have been reported on the alveolar ridge, oral mucosa, floor of the mouth, ventral tongue, and rarely other areas. We identified 61 cases of gingival PSCCA within the parameters of a larger study of 519 cases of gingival SCCA. We evaluated the clinical and histologic features of these lesions. The average age of the PSCCA patient was 74years, with a very slight male predominance of 1.2:1. The mandible was affected nearly twice as often (64%, n=39) as the maxilla (35%, n=21, and 1% of cases unspecified), and the most common location by far was the mandibular posterior region (52%, n=32). Most lesions were reportedly present over 2months in duration (48%, n=29) prior to biopsy but a significant amount of clinicians were unsure of the duration of the lesion as well (36%, n=22). Only 10 cases (16%) were reportedly present less than 2months. The most common clinical presentation was that of an erythematous or mixed white and red exophytic mass (74%, n=45). 62% (n=38) of submitting clinicians considered a malignant or premalignant lesion in their differential diagnosis, but other clinical impressions included papillomas, reactive gingival lesions, and fungal infections. Histologically, 88% (n=52 of 59 cases graded) of the lesions were either well or moderately-well differentiated. PSCCA is a rare subtype of SCCA which has been reported infrequently involving the gingiva or alveolar ridges but should be considered by clinicians for the differential diagnosis of papillary gingival masses.

Clinical, Histologic, and Computed Tomographic Features of Oral Papillary Squamous Cell Carcinoma in Dogs: 9 Cases (2008–2011)

Medical records of dogs diagnosed with oral papillary squamous cell carcinoma between December 2008 and April 2011 were reviewed. Information abstracted included signalment, tumor location, tumor size, computed tomographic (CT) features, evidence of metastatic disease based on cytologic examination of lymph node aspirates and thoracic radiography, treatment, surgical margins, histologic features, and treatment outcome. Dogs included in the study were all sexually altered, predominantly large breed dogs with a mean age of 3.9-years (range, 0.5 to 9.0-years). The most common location was the rostral maxilla. Invasion of underlying bone and lymphadenopathy were evident on CT imaging in most dogs. No evidence of metastasis was found on mandibular lymph node cytology and thoracic radiography. Histologic analysis revealed similar morphologic findings for all surgically resected tumors. Surgical excision with 1-2 cm margins was complete in all cases, with a mean tumor-free interval of 12.1-months.

Papillary Squamous Cell Carcinoma of the Trachea Associated with Human Papillomavirus-18 Infection

A 75-year-old man presented with the chief complaints of coughing and dyspnea. Chest computed tomography revealed narrowing of the trachea. A tumor measuring 40×33×15 mm in size that caused -90% reduction in the cross-sectional area of the trachea 4 cm above the carina was cauterized with high-frequency electrocautery via a rigid bronchoscope. A pathological examination revealed papillary squamous cell carcinoma with immunohistochemical p16 overexpression. Multiplex polymerase chain reaction confirmed human papillomavirus type 18 DNA in the tumor. At the 12-month follow-up visit following the administration of radiotherapy, the patient exhibited no local recurrence or distant metastasis.

転移巣に扁平上皮癌成分と乳頭癌成分とを認めた甲状腺乳頭癌肺転移の1例

症例は52歳，女性．44歳時甲状腺乳頭癌に対して甲状腺左葉切除術が施行された．検診で胸部異常陰影を指摘されて，当院紹介受診となった．CTで両肺の多発小結節と右S4肺門側に最大径30 mmの腫瘍が指摘されたため，診断及び治療目的で当科へ紹介された．術前には転移性肺癌と原発性肺癌の合併を強く疑い，手術を施行した．術中S4腫瘍の迅速病理検査では扁平上皮癌の診断が得られ，周囲の小結節は甲状腺乳頭癌の診断が得られたため，甲状腺癌肺転移と原発性肺癌の合併と診断して右肺中葉切除リンパ節郭清を施行した．術後組織診断では乳頭癌から扁平上皮癌への直接移行を認めたために，甲状腺癌肺転移と診断した．甲状腺乳頭癌の転移巣には，稀に扁平上皮癌が生じることがあることを念頭に置くことが肝要と考えられた．

Pigmented Viral-Associated Conjunctival Carcinoma

A 54-year-old African-American woman developed a pigmented papillary squamous cell carcinoma in the palpebral and bulbar conjunctiva of the right eye in areas that received no sun exposure. In situ hybridization performed on the tumor showed human papilloma virus 16. The left eye showed a pedunculated nonpigmented conjunctival dysplasia. The tumors were extirpated by cryosurgery and topical interferon alfa 2b in the right eye and simple surgical excision in the left eye.

CD44 Expression in Intraoral Salivary Ductal Papillomas and Oral Papillary Squamous Cell Carcinoma

CD44 is a transmembrane adhesion molecule which has been previously shown to be useful in the differentiation of benign papillary lesions from invasive carcinoma in several different areas including sinonasal mucosa and breast tissue. CD44 expression has previously been shown to be lost in invasive carcinoma and retained in benign papillary lesions in both of the above locations. In addition, studies have evaluated oral mucosal lesions for CD44 expression and found a loss with invasive squamous cell carcinoma when compared to normal epithelium, hyperplasia, and squamous papillomas, which stained particularly strongly. To the best of our knowledge, no study has evaluated CD44 expression when comparing salivary ductal papillomas in comparison to oral papillary SCCA. In this study 18 cases of intraductal papilloma were compared to 19 cases of oral papillary SCCA. Within the ductal papilloma group, all cases stained either absent (6%), weakly (33%), or moderately (61%) with 76% expressing the stain diffusely and 24% focally. In comparison, the papillary squamous cell carcinoma cases expressed the CD44 moderately (26%) or strongly (74%) with 100 % showing diffuse staining. Thus, the CD44 expression was contrary to expectation based on previous studies, which we hypothesize is due to the extremely well differentiated nature of papillary SCCA which expressed CD44 staining compatible with levels previously reported with oral squamous papillomas than invasive carcinoma.

Comparison of CD44 Expression in Intraoral Salivary Ductal Papillomas and Oral Papillary Squamous Cell Carcinoma

Comparison of CD44 Expression in Intraoral Salivary Ductal Papillomas and Oral Papillary Squamous Cell Carcinoma

Human papillomavirus infection and papillary squamous cell carcinoma in the head and neck region

Papillary squamous cell carcinoma (PSCC) is a rare variant of SCC in the head and neck region. The role of human papillomavirus (HPV) infection in PSCC is still unclear. We retrospectively reviewed 11 PSCCs in our institute over a 21-year period and compared the HPV status of PSCCs with 26 squamous cell papillomas (SCPs). Polymerase chain reaction (PCR) amplification to detect HPV DNA and in situ hybridization (ISH) were performed to analyze the relationship between the papillary lesions and HPV infection. Immunohistochemical (IHC) staining for p16 protein expression was used to analyze the PSCC specimens. Nine of 11 (82%), eight of 11 (73%), and eight of 11 (73%) PSCC samples were found to be HPV positive by PCR, ISH, and IHC staining for p16 protein expression, respectively. PSCC had a significantly higher rate of HPV infection than SCP by PCR (p = 0.002) and ISH (p = 0.001) analysis. This study presents different HPV status in two papillary neoplasms and may help to clarify the unique morphological and biological characteristics of head and neck PSCC.

Parameters predicting lymph node metastasis in patients with superficial esophageal squamous cell carcinoma

Endoscopic resection is a less invasive treatment than esophagectomy for superficial esophageal squamous cell carcinoma, but patients with lymph node metastasis need additional treatment after endoscopic resection. The purpose of this study was to establish a set of indicators to identify superficial esophageal squamous cell carcinoma patients at a high risk of metastasis. In all, 271 superficial esophageal squamous cell carcinoma esophagectomy cases were reviewed retrospectively. The relationships between clinicopathological parameters and immunohistochemical findings (p53, cyclin D1, EGFR and VEGF) on tissue microarrays, on the one hand, and lymph node metastasis were assessed by univariate and multivariate logistic regression analyses. Patients with intraluminal masses and ulcerated masses had a high risk of lymph node metastasis. Patients with superficial esophageal squamous cell carcinoma (1) thinner than 1200 μm; (2) confined to the mucosa; (3) with submucosal invasion <250 μm; (4) with submucosal invasion ≥250 μm but with negative VEGF expression and well/moderately differentiated or basaloid histology; or (5) with submucosal invasion ≥250 μm but with weak VEGF expression and well-differentiated histology had almost no risk of lymph node metastasis. We recommend endoscopic resection for all erosive, papillary and plaque-like superficial esophageal squamous cell carcinomas where endoscopic resection is clinically feasible, and esophagectomy for all other erosive, papillary and plaque-like cases and all intraluminal masses and ulcerated tumors. No additional treatment is needed for endoscopic resection cases with superficial esophageal squamous cell carcinoma (1) thinner than 1200 μm; (2) confined to the mucosa; (3) with submucosal invasion <250 μm; (4) with submucosal invasion ≥250 μm but with negative VEGF expression and well/moderately differentiated or basaloid histology; or (5) with submucosal invasion ≥250 μm but with weak VEGF expression and well-differentiated histology. These clinical and pathological criteria should enable more accurate selection of patients for these procedures.

Papillary squamous cell carcinoma of the oral mucosa: a clinicopathologic and immunohistochemical study of 12 cases and literature review

Papillary squamous cell carcinoma (SCC) (PSCC) of the oral mucosa is a relatively rare but distinct variant of SCC of head and neck. The objectives of this study were to describe the clinicopathologic and immunohistochemical features of a series of patients with oral PSCC and to review the literature on this topic. Retrospective review of patients with clinical and pathologic diagnosis of PSCC (n = 12) between 2000 and 2008 in our institution was conducted. The outcome analysis in a mean follow-up of 56 months (range, 24-131 months) was performed. These patients were 7 women and 5 men, and the mean age at diagnosis was 72.9 years (range, 53-83 years). The cheek and the gingiva were the predominant sites of involvement. At the end of follow-up, 4 patients were found to have local recurrence, and 3 were dead of disease. The estimated 3- and 5-year survival was 91.7% and 76.4% for the whole series, respectively. Histopathologically, the papillary pattern consisted of multiple, thin, delicate filiform, finger-like papillary projections with fibrovascular cores. Besides, the exophytic pattern consisted of the broad-based bulbous to "cauliflower-like" exophytic growth with rounded projections. Immunohistochemically, positivity for CKpan, CKhmw (high molecular weight), and p53, yet negativity for CK8, vimentin, desmin, smooth muscle actin, and S-100 was observed in PSCC. In conclusion, 2 specific histopathologic growth patterns of oral PSCC were identified to separate from conventional SCC. Patients with PSCC have a favorable outcome in relation to exophytic nature and limited invasion of the tumor.

Basaloid Squamous Cell Carcinoma of the Penis With Papillary Features

There are 3 distinct variants of penile squamous cell carcinoma frequently associated with human papillomavirus (HPV): basaloid, warty-basaloid, and warty carcinomas. Considering the high incidence rates of penile cancer in some countries, a large international study was designed to evaluate the presence of HPV, its genotype distribution, and its association with histologic types of penile cancer. In this international review of >900 cases, we found a group of highly distinct papillary neoplasms composed of basophilic cells resembling urothelial tumors but frequently associated with HPV. Macroscopically, tumors were exophytic or exoendophytic. Microscopically, there was a papillomatous pattern of growth with a central fibrovascular core and small basophilic cells lining the papillae. Positivity for HPV was present in 11 of 12 tumors (92%). Single genotypes found were HPV-16 in 9 tumors and HPV-51 in 1 tumor. Multiple genotypes (HPV-16 and HPV-45) were present in another case. Overexpression of p16 was observed in all cases. Uroplakin-III was negative in all cases. The differential diagnosis was with basaloid, warty-basaloid, warty, and papillary squamous cell carcinoma and with urothelial carcinomas. Local excision (4 cases), circumcision (3 cases), or partial penectomy (5 cases) were preferred treatment choices. Tumor thickness ranged from 1 to 15 mm (average, 7 mm). Two patients with tumors invading 11 and 15 mm into the corpus spongiosum developed inguinal nodal metastasis. Of 11 patients followed up (median 48 mo), 7 were alive with no evidence of metastatic disease, 3 died from causes other than penile cancer, and another died postoperatively. This morphologically distinct tumor probably represents a papillary variant of basaloid carcinomas (papillary-basaloid carcinomas). Unlike typical basaloid carcinomas, the overall prognosis was excellent. However, deeply invasive tumors were associated with regional nodal metastasis indicating a potential for tumor-related death.

Clinicopathologic features of oral squamous papilloma and papillary squamous cell carcinoma: a study of 197 patients from eastern China

Oral squamous papilloma and papillary squamous cell carcinoma are 2 clinicopathologically distinctive papillary epithelial tumors. The current study aims to compare the clinical and pathologic features of these oral papillary lesions in a patient population from eastern China. A retrospective review in a series of patients with clinical and pathologic diagnosis of oral squamous papilloma (n = 141) and papillary squamous cell carcinoma (n = 56) was conducted. The average age of oral squamous papilloma was 51.0 years (male-to-female ratio, 1.82), with the palate being the predominant site. The average age of oral papillary squamous cell carcinoma was 63.3 years (male-to-female ratio, 1.67), with the gingiva being the predominant site. Multivariate analysis revealed that the elderly patient with papillary lesion (≥60 years) was associated with 3.09-fold (95% confidence interval, 1.59-6.03) increased carcinoma risk compared with the nonelderly patient. The lesion located on the gingiva was associated with 4.98-fold (95% confidence interval, 1.96-12.63) increased carcinoma risk compared with other oral sites. Collectively, clinicopathologic features of oral squamous papilloma and papillary squamous cell carcinoma in eastern China were elucidated. Elderly patients with oral papillary lesions located on the gingiva correlate with higher carcinoma risk. It highlights the importance of using a histologic examination to confirm the clinical diagnosis for any suspicious papillary lesions.

Papillary Squamous Cell Carcinoma of the Uterine Cervix with Negative HPV: Report of a Case and Literature Review

Abstract Background: Squamous-cell carcinoma (SCC) is the most common type of cancer of the uterine cervix. It has several unusual histologic variants. The prognosis and treatment may vary with the histologic type. Papillary squamous-cell carcinoma (PSCC) is one of these unusual variants; it has been poorly reported in the literature. This subtype has distinctive histologic and clinical characteristics and differs from other papillary lesions of the cervix, including: condyloma; verrucous carcinoma; papillary immature metaplasia; and typical SCC. PSCC is characterized by the appearance of late recurrences and metastasis. The involvement of HPV in SCC pathophysiology is not well-established. PSCC is treated in a similar manner to the usual SCC; however PSCC is more sensitive to radiotherapy than SCC is. After reporting on a rare new case of PSCC that was negative for PSCC, this article describes PSCC's clinicopathological features and shows the phenotypic and genotypic differences between PSCC and typical ...

Histological Subtypes of Oral Non-tonsillar Squamous Cell Carcinoma in Dogs

Several histological subtypes and grades of oral squamous cell carcinoma (SCC) are described in human literature and these subtypes have distinct morphological features and biological behaviour. This retrospective study (1990-2010) included 84 dogs diagnosed with SCC of the oral cavity and oropharynx, excluding the tonsils. Sixty-nine of the SCCs (82.1%) were further diagnosed as conventional SCC (CSCC) (33 [47.8%] well-differentiated, 31 [44.9%] moderately-differentiated and five [7.3%] poorly-differentiated), five (5.95%) each as papillary SCC and basaloid SCC, three (3.6%) as adenosquamous carcinoma and two (2.4%) as spindle cell carcinoma. Compared with the general hospital population, neutered female dogs, dogs aged 10 to <15 years, English springer spaniels and Shetland sheepdogs were overrepresented. The majority (78.1%) of SCCs were proliferative with or without associated ulceration, although no significant association was observed between the gross appearance and different SCC subtypes. 71.4% of SCCs were located in dentate jaws; however, well-differentiated CSCC more often affected the tongue and other non-dentate mucosal surfaces (P=0.0022). No significant association was found between any of the SCC subtypes and tumour-associated inflammation (TAI), perineural and lymphovascular invasion (PNI, LVI), or between gross appearance of the tumour and tumour location, PNI, LVI or TAI or PNI, LVI, TAI and tumour location.

Mandibular cuniculatum carcinoma: Apropos of 3 cases and literature review

Cuniculatum carcinoma is a well-differentiated form of squamous cell carcinoma that shares histologic characteristics with papillary squamous cell carcinoma and verrucous carcinoma. Cuniculatum carcinoma usually occurs on the plantar region, and only 16 cases involving the oral cavity have been described in the literature. The authors have reported 3 cases of mandibular cuniculatum carcinoma. All of the patients were in a great deal of pain. Histologic diagnosis was difficult due to the presence of few cellular atypies. Clinical criteria, osseous lysis, and the coexistence of multiple intraosseous well-differentiated, hyperkeratotic papillomatous lesions with few cellular atypies sign the diagnosis. No local recurrence has been reported after treatment with radical surgery alone. The diagnosis is often delayed. Although cuniculatum carcinoma displays aggressive behavior locally, lymph node infiltration and metastasis are rare. The therapy of choice is surgical removal with free margins, after which the prognosis is excellent.

Wyniki odległe operacji częściowych u chorych na raka krtani

The aim of the study was to evaluate the results of partial laryngectomies in patients with laryngeal cancer treated in the 2(nd) Clinical Department of Laryngology SUM in Zabrze in the years 1990-2000. Retrospective clinical material includes 209 patients in whom surgery was a primary treatment method. No distant metastases (M1) or another malignant cancer were found. The group consisted of 20 (10%) women and 189 (90%) men. The mean age was - 51.2 years. The stage of the neoplasm progression was defined as T1 in 91 patients (44%), T2 in 109 patients (52%). In other 9 patients (4%) the progression stage was T3 and T4. Clinical examination in 191 patients (91%) did not show enlarged lymph nodes in the area of head and neck (N0). In the group of remaining 18 patients (9%) the node progression was found to be N1-N3. In all 209 patients the squamous cell carcinoma of various stage of malignancy (G1-G3) was found in preoperative histopathological tests, out of which five cases were of papillary squamous cell carcinoma. The most common operation in the analyzed group was a chordectomy - 83 surgeries (40%), followed by 38 (18%) vertical partial laryngectomies, 28 (13%) horizontal glottis surgeries, 19 (9%) frontal-lateral and frontal-anterior operations, and supracricoid operations with a reconstruction of CHEP and CHP type, a total of 20 operations (9%). Other types of partial operations were performed less commonly. In 79 patients (38%) partial laryngectomy was complemented with a nodal operation, while cervical lymph nodes were not removed in 130 patients (62%). In 19 cases (9%) the metastases of squamous cell carcinoma to regional lymph nodes were confirmed in postoperative material. 82 patients of the study group (39%) underwent radiotherapy. The median of the observation period was 9 years. Local recurrence, nodal recurrence and distant metastasis are rated as treatment failure. Treatment effectiveness was evaluated with relation to local control, overall survival, disease-free survival and cause specific survival. All the aforementioned parameters were analyzed with the method of updated percentages. The level of statistical significance was assumed to be p ≤ 0.05. The updated 5-year and 10-year percentage of overall survivals was respectively 75% and 63%. The updated 5-year and 10-year percentage of cancer specific survivals was 85% and 79%, respectively. The updated 5-year and 10-year percentage of disease-free survivals was 72% and 56%, respectively. The percentage of 5-year and 10 year local controls was 86% and 79%, respectively.

Papillary Squamous Cell Carcinoma of thec Larynx

Papillary squamous cell carcinoma is a rare variant of squamous cell carcinoma of the aerodigestive tract that has been correlated with a more favorable prognosis than conventional squamous cell carcinoma of the head and neck. In this report, the authors present a case of papillary squamous cell carcinoma and a review of the literature on this topic.

Not Your Usual Cancer Case: Variants of Laryngeal Squamous Cell Carcinoma

Although squamous cell carcinoma (SCC) variants account for less than 10% of all laryngeal SCCs, they have many unique biological, morphological, and clinical features. They are also easily confused with other tumor types. Recognition of them is critical for surgical pathologists as is the knowledge of what they mean for the patient. Three of the most common and important of these are basaloid, verrucous, and papillary SCC. These tumor types will be briefly reviewed with a focus on specific controversies, biological questions, and/or recent advancements in our understanding of them.