Variant Of Squamous Cell Carcinoma Research Articles

Consider Carcinoma cuniculatum in recurrent foot ulcer: A case report and literature review

Carcinoma Cuniculatum is a variant of Squamous Cell Carcinoma, characterized by a slow growth with progressive crypt-like invasion of deep tissue. This tumor is frequently misdiagnosed as a benign skin lesion both clinically and histopatologically. The final diagnosis is often delayed as it requires a large sample biopsy. We report the case of a 67 year old patient which presented to us with a recurring chronic ulcer over a surgical scar of five years of evolution. Only after a wide resection of the chronic ulcer was it possible to achieve the correct diagnosis of this large and poorly evolving carcinoma. The subsequent reconstruction with a musculocutaneous gracilis free flap allowed the patient to walk again.

PLANTAR CARCINOMA CUNICULATUM: A RARE PRESENTATION IN THE FOOT REGION

Carcinoma cuniculatum is a rare variant of squamous cell carcinoma. The clinical presentation is usually a non-verrucous exophytic plaque or tumor of the plantar region with a penetration in the deep tissues. Histological examination shows a proliferation of well-differentiated keratinocytes. We describe a patient affected by a slowly enlarging tumoral lesion overlying the fifth metatarsum of the left foot. Clinical examination and radiological investigations suggested a chronic osteomyelitis and a first histological examination of a punch biopsy was suggestive of a pseudo-epitheliomatous hyperplasia. The patient underwent several cycles with systemic antibiotics without improvement. Finally, the fifth metatarso was amputated and the skin lesion was completely removed. The histological examination of the whole operatory mass allowed a diagnosis of carcinoma cuniculatum invading the bone.

Case Report: Basaloid Squamous Cell Carcinoma of the Tongue: A Case Report

Basaloid squamous cell carcinoma (BSCC) is a rare variant of conventional squamous cell carcinoma (SCC) frequently affecting the upper aerodigestive tract. The hypopharynx, tonsil, supraglottic larynx, tongue (base), and head-neck regions are particularly susceptible to BSCC. Clinically, the presentation of BSCC and conventional SCC is similar, but BSCC has a poorer prognosis. BSCC is distinguished histopathologically by a dimorphic pattern, a distinctive basal cell component paired with a squamous component. However, its similar features to conventional SCC makes it difficult to diagnose. Therefore, histopathology and immunohistochemistry play a crucial role in diagnosing such tumors. Here we present the case of a 70-year-old male diagnosed with BSCC involving the tongue.

Enigma of Acantholytic and Clear Cell Changes in Oral Squamous Cell Carcinoma.

Only limited cases have been reported about the clear cell variant of squamous cell carcinoma occurring in the oral cavity. The present study regards the case showing the histopathological features of both the clear cell and acantholytic variants of oral squamous cell carcinoma. A review of the literature has been done to understand the pathogenesis of those changes. Also, a hypothesis has been given that the clear cell changes could be the consequences of the cascades of the acantholytic process and not a separate entity. Therefore, more research is required to confirm this hypothesis and understand the prognosis of the lesion.

Oral Verrucous Carcinoma: Case Report

Verrucous carcinoma is usually considered a low-grade variant of squamous cell carcinoma. Our case is a 56-year-old woman presented to our department of maxillofacial surgery of Ibn Sina hospital in Rabat with a budding lesion of the upper lip evolving 2 years ago. The diagnosis retained was that of well-differentiated squamous cell carcinoma of the verrucous type with infiltration of the chorion. The therapeutic decision was to perform a surgical excision with a safety margin of 1 cm followed by suturing of the defect and commissuroplasty. Its diagnosis is based on clinical and histological features. The treatment is not well codified. Surgery remains the treatment of choice.

Acantholytic squamous cell carcinoma of larynx: An unusual cause of asphyxial death diagnosed on autopsy

Acantholytic squamous cell carcinoma (ASCC) is an uncommon histopathological variant of squamous cell carcinoma (SCC). This tumor commonly occurs in the sun exposed areas of skin at the head and neck location. The possible occurrence at mucosal sites has seldom been reported. Although, this malignant tumor has an excellent prognosis in the skin, in sharp contrast, mucosal involvement carries a worse prognosis. Here, we explore an intriguing case of an asphyxial death of a 35-year-old man due to a polypoidal mass occluding the airway in the glottic region. Subsequently, based on the histopathological and immunohistochemical findings, the cause of death was diagnosed as ASCC based on histopathological and immunohistochemical findings. Furthermore, this report also highlights the rarity of this variant of SCC at an uncommon location, thus making it the third case ever reported in literature. The other interesting fact about this case is that most of the published reports in the literature have described and diagnosed this rare variant on antemortem examination; contrarily, a postmortem diagnosis of ASCC is exceptional, making it the first report ever in history.

Oral carcinoma cuniculatum, a rare variant of squamous cell carcinoma

IntroductionCarcinoma cuniculatum (CC) is a rare variant of squamous cell carcinoma (SCC). Lack of awareness of this tumor and its difficult diagnosis delay management and complicate treatment. The aim of this study is to describe the clinical and histological features, predisposing factors, treatment and survival rate of oral carcinoma cuniculatum. Material & methodAll patients with histologically confirmed CC of the oral cavity treated between January 2013 and August 2022 in a specialized center were retrospectively included. Patients were identified using the database ADICAP (“Association pour le Développement de l'Informatique en Cytologie et Anatomie Pathologique”). Once identified, the charts were reviewed. ResultsTen patients were included. CC lesions were mainly located in the mandibular or maxillary gingiva, while the 2 remaining lesions were located in the mobile tongue. The tumor showed local aggressiveness: mandibular or maxillary osteolysis was systematically found for gingival CC, while tongue lesions were classified cT3. Fifteen biopsies were performed in these 10 patients, histological diagnosis is difficult on a limited tissue sample. All patients underwent curative management with oncological excision surgery combined with neck lymph node dissection, and adjuvant radiotherapy (except one patient). DiscussionThe main problem is the difficulty of diagnosis when biopsies are performed, which leads to a significant delay in diagnosis compared with SCC. In the event of clinico-histological discordance after biopsy, CC should be considered.

Papillary Variant of Oral Squamous Cell Carcinoma of Alveolar Mucosa- A Case Report and Review

Papillary Squamous Cell Carcinoma (PSCC) is a less frequent subtype of Squamous Cell Carcinoma (SCC) with a more favorable prognosis compared to conventional oral squamous cell carcinoma. PSCC has a distinctive exophytic and papillary projection. The upper aerodigestive tract is the most commonly affected site with a higher incidence of occurrence in the larynx. The papillary variant of oral squamous cell carcinoma involving gingiva or alveolar ridge is relatively uncommon and less reported. Other differential diagnosis of papillary gingival masses is reactive gingival lesions and fungal infections. An accurate diagnosis is vital for both therapeutic and prognostic purposes. This article describes the case of papillary variant oral squamous cell carcinoma in a 75-year-old male in the maxillary alveolar region depicting histopathological features of exophytic growth with hyperplastic stratified squamous epithelium with basaloid cells invading the underlying connective tissue.

Squamotransitional Cell Carcinoma of the Uterine Cervix with Ovarian Metastasis and Benign Brenner Tumor: A Case Report

Introduction: Cervical cancer is the fourth most common malignancy in women and the fourth leading cause of death among women. The main histological types of cervical cancer are squamous cell carcinoma—75% of all cases; adenocarcinoma—10–25%; and all other rare variants including adenosquamous carcinoma and neuroendocrine carcinoma. Squamotransitional cervical cancer is an extremely rare and poorly studied subtype of squamous cell carcinoma. Case report: We present a case of a 64-year-old female patient with early-stage squamotransitional carcinoma. A metastasis was observed in the left ovary and the left fallopian tube and a benign Brenner tumor in the right ovary. Discussion: Although it is believed that this cervical cancer subtype shares the same risk factors and prognosis as squamous cell carcinoma, it is more likely to metastasize and recur. It is not unusual for spread to exist within nearby structures like the cervix and adnexa. It is impossible to tell which is the predominant focus from the immunoprofile of the lesions. Practically speaking, the best course of action in these situations is to rule out the presence of a primary tumor in the urinary tract before clarifying the condition of the cervix, uterus, and adnexal tissues. The presence of a Brenner tumor raises the possibility of a connection between the tumor’s differentiation from a cell population and potential urothelial differentiation. Conclusion: Squamotransitional cervical cancer is a rare tumor with a poorly studied clinical behavior. Despite a shortage of information in the literature, it should be regarded as a more aggressive variety of squamous cell carcinoma and, as such, should be treated and followed up more aggressively. This case is the first described with involvement of the cervix, endometrium, and adnexal structures and a concomitant Brenner tumor.

Nasopharyngeal carcinoma with non-squamous phenotype may be a variant of nasopharyngeal squamous cell carcinoma after inhibition of EGFR/PI3K/AKT/mTOR pathway.

Nasopharyngeal carcinoma (NPC) is a cancerous tumor that develops in the nasopharynx epithelium and typically has squamous differentiation. The squamous phenotype is evident in immunohistochemistry, with diffuse nuclear positivity for p63 and p40. Nonetheless, a few NPCs have been identified by clinicopathological diagnosis that do not exhibit the squamous phenotype; these NPCs are currently referred to as non-squamous immunophenotype nasopharyngeal carcinomas (NSNPCs). In a previous work, we have revealed similarities between the histological appearance, etiology, and gene alterations of NSNPC and conventional NPC. According to ultrastructural findings, NSNPC still falls under the category of non-keratinized squamous cell carcinoma that is undifferentiated. NSNPC has an excellent prognosis and a low level of malignancy, according to a retrospective investigation. Based on prior research, we investigated the molecular mechanism of NSNPC not expressing the squamous phenotype and its biological behavior. IHC was used to determine the expression of EGFR, PI3K, AKT, p-AKT, mTOR, p-mTOR, Notch, STAT3 and p-STAT3 in a total of 20 NSNPC tissue samples and 20 classic NPC tissue samples. We obtained human NPC cell lines (CNE-2,5-8F) and used EGFR overexpression plasmid and shRNAs to transfect them. To find out whether mRNA and proteins were expressed in the cells, we used Western blotting and qRT-PCR. Cell biological behavior was discovered using the CCK-8 assay, cell migration assay, and cell invasion assay. EGFR, PI3K, p-AKT and p-mTOR proteins were lowly expressed in NSNPC tissues by immunohistochemistry, compared with classical NPC. In the classical NPC cell lines CNE-2 and 5-8F, overexpression EGFR can up-regulate the expression of p63 through the PI3K/AKT/mTOR pathway, and promote the proliferation, migration, and invasion of nasopharyngeal carcinoma cells. At the same time, knockout of EGFR can down-regulate p63 expression through the PI3K/AKT/mTOR pathway, and inhibit the proliferation, migration, and invasion of nasopharyngeal carcinoma cells. The lack of p63 expression in NSNPC was linked with the inhibition of the EGFR/PI3K/AKT/mTOR pathway, and NSNPC may be a variant of classical NPC.

AKAP12 inhibits esophageal squamous carcinoma cell proliferation, migration, and cell cycle via the PI3K/AKT signaling pathway

Esophageal squamous cell carcinoma (ESCC) consistently ranks as one of the most challenging variants of squamous cell carcinomas, primarily due to the lack of effective early detection strategies. We herein aimed to elucidate the underlying mechanisms and biological role associated with A-kinase anchoring protein 12 (AKAP12) in the context of ESCC. Bioinformatic analysis had revealed significantly lower expression level of AKAP12 in ESCC tissue samples than in their non-cancerous counterparts. To gain deeper insights into the potential role of AKAP12 in the progression of ESCC, we conducted a single-gene set enrichment analysis of AKAP12 on ESCC datasets. Our findings suggested that AKAP12 exhibits functions inhibiting cell cycle progression, tumor proliferation, and epithelial-mesenchymal transition. To further validate our findings, we subjected ESCC cell lines to AKAP12 overexpression using CRISPR/Cas9-SAM. In vitro analyses demonstrated that increased expression of AKAP12 significantly reduced cell proliferation, migration, and cell cycle progression. Simultaneously, genes associated with this biological role undergo corresponding regulatory shifts. These observations provided valuable insights into the biological role played by AKAP12 in ESCC progression. In summary, AKAP12 shows promise as a new potential biomarker for early ESCC diagnosis, offering potential advantages for subsequent therapeutic intervention and disease management.

Spindle cell carcinoma of the larynx: a rare entity

Squamous cell carcinoma (SCC) is the commonest malignancy encountered in the larynx in the Indian population. Spindle cell carcinoma is an extremely rare malignant tumor and is a variant of SCC with a mesenchymal like malignant cell component. This is a case report of a 58 years old patient who presented with hoarseness of voice of 7 months duration. He was diagnosed to have a right vocal cord polypoidal growth with mobile vocal cords. He underwent direct laryngoscopy and biopsy of the lesion which was reported as spindle cell neoplasm/inflammatory myofibroblastic tumor (IMT). Immunohistochemistry (IHC) was carried out and confirmed the diagnosis of inflammatory myofibroblastic tumor. He was doing well and the follow up videolaryngoscopic examinations and PET CT were normal. At subsequent follow-up 19 months later, he was found to have a recurrent right vocal cord lesion. Direct laryngoscopy and biopsy was repeated along with laserization of the right vocal cord. Histopathology was reported as spindle cell malignant neoplasm. Immunohistochemistry was reported as spindle cell carcinoma. He was then sent for radiation therapy. The patient responded well to radiation and is tumor free at last follow-up. He has been advised regular follow-ups. Spindle cell carcinoma is an extremely rare laryngeal malignancy. It typically originates in the glottis. The treatment for spindle cell carcinoma includes surgery, radiation or a combination of these modalities. Its prognosis is worse than squamous cell carcinoma and patients require close follow-ups.  

Management of Cutaneous Squamous Cell Carcinoma (Clear Cell Variant) in Bovine - A Case Report

Tumors of the bovine gastrointestinal tract are rare, possibly  because of the low age of the sample population (Bertone,  1990). Neoplasia in cattle carries a poor prognosis because  of early adenocarcinoma metastasis and the high fatality  of lymphosarcoma. Squamous cell carcinoma is the second  most rude type of skin cancer, with basal cell carcinoma  being the most common (Rinker et al., 2001). Squamous cell  carcinoma has been documented in bovine (Musser et al., 1993). Clear-cell squamous cell carcinoma is a rare variant  of squamous cell carcinoma, first described by Kuo (1980)  as a skin tumor. The exact etiology is unclear, but ultraviolet  radiation has been suggested as a possible cause in humans  (Lawal et al., 2013). This report documents a case of cutaneous  squamous cell carcinoma (clear cell variant) in perianal region  of a cow and its successful surgical management. 

A rare presentation of orbital spindle cell carcinoma a case report and brief review of the literature

BackgroundTo describe a case of orbital spindle cell carcinoma which presented with limbal ischemia and briefly review the literature.MethodsRetrospective case report and brief literature review.ResultsA 61-year old man presented with blepharoptosis, periorbital pain, decreased vision and limbal ischemia. He did not mention any previous illness and did not take any kind of drugs. Imaging revealed an orbital mass that was positive for SMA, Vimentin and CD99 and negative for S100. We treated the patient with chemotherapy and followed him for other complications that occurred throughout disease course.ConclusionSpindle cell carcinomas are a rare variant of squamous cell carcinoma (SCC) with dual malignant histologic differentiation of squamous and mesenchymal cells. Few cases of orbital spindle cell carcinoma have been reported, which have been either secondary to distant metastasis or regional spread. In this study, we have reported the first case of primary orbital spindle cell carcinoma presenting with limbal ischemia. Further studies are needed to describe the different clinical presentations and management strategies of this rare clinical entity.

Rare cutaneous verrucous carcinoma in the femoral region: a case report

BackgroundVerrucous carcinoma (VC) is a well-differentiated variant of squamous cell carcinoma (SCC) characterized by slow growth and low metastatic potential. Cutaneous verrucous carcinoma (CVC) or papillomatosis cutis carcinoides is the term used for VC in other locations than the oral, anogenital, and plantar regions. This rare tumor has a contradictory “benign” histology, but markedly aggressive clinical behavior. We present this case as background knowledge to corroborate clinical course, diagnosis, histopathology, and treatment options for this infrequent disease. Case DescriptionWe report a verrucous carcinoma on a 79-year-old man’s left thigh. Clinical examination showed a fungating mass with cauliflower-like appearance measuring 5x3x1 cm. Excisional biopsy revealed exo-endophytic proliferation of well-differentiated squamous epithelium invading the dermis with marked hyperkeratosis, parakeratosis, acanthosis, papillomatosis, pushing margins, and minimal cellular atypia (T2N0M0). It was successfully treated by wide local excision, inguinal lymph node dissection, and adjuvant radiotherapy. Follow-up after 1 year showed good wound healing without any loss of function or recurrence. ConclusionCutaneous verrucous carcinoma is a subtype of a low-grade SCC and is not an SCC with a verrucous presentation. Identification of the clinicopathological features is essential to distinguish CVC from its mimics and to make an early diagnosis. Although slow growth and confusing early-stage appearances can lead to delay in diagnosis or to misdiagnosis, this case has not raised many diagnosis problems regarding the cardinal manifestations of CVC. Regardless of any available therapeutic methods, surgical excision with safety margins is still a priority and CVC requires aggressive treatment.

DCUN1D1 Is an Essential Regulator of Prostate Cancer Proliferation and Tumour Growth That Acts through Neddylation of Cullin 1, 3, 4A and 5 and Deregulation of Wnt/Catenin Pathway.

Defective in cullin neddylation 1 domain containing 1 (DCUN1D1) is an E3 ligase for the neddylation, a post-translational process similar to and occurring in parallel to ubiquitin proteasome pathway. Although established as an oncogene in a variety of squamous cell carcinomas, the precise role of DCUN1D1 in prostate cancer (PCa) has not been previously explored thoroughly. Here, we investigated the role of DCUN1D1 in PCa and demonstrated that DCUN1D1 is upregulated in cell lines as well as human tissue samples. Inhibition of DCUN1D1 significantly reduced PCa cell proliferation and migration and remarkably inhibited xenograft formation in mice. Applying both genomics and proteomics approaches, we provide novel information about the DCUN1D1 mechanism of action. We identified CUL3, CUL4B, RBX1, CAND1 and RPS19 proteins as DCUN1D1 binding partners. Our analysis also revealed the dysregulation of genes associated with cellular growth and proliferation, developmental, cell death and cancer pathways and the WNT/β-catenin pathway as potential mechanisms. Inhibition of DCUN1D1 leads to the inactivation of β-catenin through its phosphorylation and degradation which inhibits the downstream action of β-catenin, reducing its interaction with Lef1 in the Lef1/TCF complex that regulates Wnt target gene expression. Together our data point to an essential role of the DCUN1D1 protein in PCa which can be explored for potential targeted therapy.

Perianal Cutaneous Spindle Cell Squamous Cell Carcinoma With Myxoid Stroma: Case Report and Literature Review.

Spindle cell squamous cell carcinoma with myxoid stroma is a rare variant of squamous cell carcinoma with sarcomatoid morphology. We report a case of a 75-year-old woman with an ulcerated polypoid cutaneous mass in the perianal area. The patient had a history of clear cell renal cell carcinoma. Microscopy revealed an invasive myxoid spindle cell carcinoma without the classic squamous cell carcinoma component. The immunohistochemical study demonstrated diffuse positive reactions for p63, AE1/3, and CK5/6. The tumor cells were negative for desmin, smooth muscle actin, S100, and CD34. Fluorescent in situ hybridization was negative for EWSR1 gene rearrangement. Follow-up was remarkable for recurrence of tumor in 2 months after complete resection with negative surgical margin. This is the first case report of perianal spindle cell squamous cell carcinoma with myxoid stroma with a literature review of previous case reports from different locations.

Basaloid squamous cell carcinoma: A rare and aggressive cancer of the oral cavity

Basaloid squamous cell carcinoma (BSCC) is an uncommon and severe variant of squamous cell carcinoma (SCC). The tumor arises most commonly in the region of the head-and-neck. It is normally seen in the epiglottis, pyriform fossa, and the base of the tongue. It also occurs less frequently in areas like the palate, buccal mucosa, gingiva and the floor of mouth. Once compared to SCC, BSCC is documented for its aggressiveness in the head-and-neck area, along with its recurrence in local and cervical lymph nodes for its distant metastasis to the lungs. In addition, local lymph nodes are more common in regular recurrence rates. BSCC in the head and neck is more likely to spread to other parts of the body. It has an increased tendency to metastasize when compared with other tumors. We report a rare case of a BSCC arising in the buccal mucosa in a 65-year-old male patient and explain its clinicopathologic characteristics.

CONVENTIONAL SQUAMOUS CELL CARCINOMA COEXISTING WITH A VERRUCOUS CARCINOMA: A HYBRID NEOPLASM

Verrucous carcinoma (VC) is a low-grade variant of squamous cell carcinoma (SCC) that lacks the cytological features of malignancy and does not metastasize, differently from the conventional SCC. Oral hybrid verrucous carcinoma is a rare neoplasm comprised of VC and conventional SCC. This study presents a case report of this hybrid neoplasm in an 81-year-old male former smoker. In the intraoral examination, the patient exhibited a white lesion with a verrucous surface in the maxillary alveolar ridge. Under clinical hypothesis of VC or conventional SCC, an incisional biopsy was performed. Microscopically, the tumor showed an endophytic proliferation of hyperkeratinized squamous epithelium with parakeratin plugging and bulbous rete ridges extending in depth. Areas of infiltration by trabeculae and islands of well-differentiated SCC were also observed. The final diagnosis was SCC coexisting with a hybrid verrucous carcinoma (VC). The patient was referred to a head and neck service and is undergoing treatment. Verrucous carcinoma (VC) is a low-grade variant of squamous cell carcinoma (SCC) that lacks the cytological features of malignancy and does not metastasize, differently from the conventional SCC. Oral hybrid verrucous carcinoma is a rare neoplasm comprised of VC and conventional SCC. This study presents a case report of this hybrid neoplasm in an 81-year-old male former smoker. In the intraoral examination, the patient exhibited a white lesion with a verrucous surface in the maxillary alveolar ridge. Under clinical hypothesis of VC or conventional SCC, an incisional biopsy was performed. Microscopically, the tumor showed an endophytic proliferation of hyperkeratinized squamous epithelium with parakeratin plugging and bulbous rete ridges extending in depth. Areas of infiltration by trabeculae and islands of well-differentiated SCC were also observed. The final diagnosis was SCC coexisting with a hybrid verrucous carcinoma (VC). The patient was referred to a head and neck service and is undergoing treatment.

THE MULTIDISCIPLINARITY IMPORTANCE IN REHABILITATION AFTER THE VERRUCOUS CARCINOMA DIAGNOSIS: A CASE REPORT

Verrucous carcinoma of the oral cavity is low-grade and a rare variant of squamous cell carcinoma. This lesion is described as malignant, exophytic, slowly growing, and locally invasive. The following case aims to report how the lesion localization and tissue healing led to a difficult rehabilitation. An 86-year-old, Caucasian female patient was referred for rehabilitation after having performed partial maxillectomy. Before surgery, a unique lesion with an irregular appearance and with papillary projections was observed. Histologically, it has shown epithelial ridges without significant dysplasia and keratin plugs. Her clinical history was collected and confronted with the anatomopathological exam, confirming verrucous carcinoma in the anterior maxillary ridge. A second surgical intervention, using high-intensity laser therapy, was necessary to improve the maxilla into a better prosthetic bed, increasing retentive areas. A healing guide plate was installed in the immediate post-surgery time to support the tissue before implementing the reparatory prosthesis. Verrucous carcinoma of the oral cavity is low-grade and a rare variant of squamous cell carcinoma. This lesion is described as malignant, exophytic, slowly growing, and locally invasive. The following case aims to report how the lesion localization and tissue healing led to a difficult rehabilitation. An 86-year-old, Caucasian female patient was referred for rehabilitation after having performed partial maxillectomy. Before surgery, a unique lesion with an irregular appearance and with papillary projections was observed. Histologically, it has shown epithelial ridges without significant dysplasia and keratin plugs. Her clinical history was collected and confronted with the anatomopathological exam, confirming verrucous carcinoma in the anterior maxillary ridge. A second surgical intervention, using high-intensity laser therapy, was necessary to improve the maxilla into a better prosthetic bed, increasing retentive areas. A healing guide plate was installed in the immediate post-surgery time to support the tissue before implementing the reparatory prosthesis.