Variant Of Squamous Cell Carcinoma Research Articles

Clinical features, surgical management and outcome of squamous and basal cell carcinoma in squamates and chelonians.

Squamous cell carcinoma (SCC) is one of the most commonly diagnosed neoplastic disorders in reptiles. Recently, however, it has been demonstrated that basal cell carcinomas (BCCs) are frequently misclassified as SCCs. Several histological SCC and BCC variants have been characterised and their classification may allow the establishment of appropriate prognosis estimation and treatment approaches. To describe the clinical features and surgical outcomes of SCCs and BCCs diagnosed between 2010 and 2022 in reptiles. Thirty-three captive reptiles (21 squamates and 12 chelonians). Detailed clinical history, including staging and surgical outcomes, were performed. Statistical analysis assessed significant factors using Prism (v8.2.1). While SCC was predominantly diagnosed in lizards, BCC was most commonly diagnosed in chelonians, and both neoplasms mainly occurred in adult to aged, male individuals. Although the gross pathological findings were highly comparable between SCC and BCC, considerable variation could be seen according to the primary location (oral, cutaneous or epidermis of the shell). Humane euthanasia or noncurative intent surgeries were performed in a minority of the cases. Curative intent surgeries were successful in 19 of 27 cases during a 1- to 7-year follow-up period, yet recurrence was seen in 8 cases. The results of this study allowed the identification of significant high-risk prognostic factors for SCC and BCC in reptiles. This study contributes to predicting the clinical behaviour and prognosis of distinct SCC and BCC histological variants, and selecting the most appropriate treatment protocol.

Carcinoma Cuniculatum Masquerading as Eumycetoma: An Unacquainted Entity Posing a Diagnostic Dilemma.

Carcinoma cuniculatum (CC) is a rare and distinct clinicopathological variant of well-differentiated squamous cell carcinoma. It is a rare and slow-growing tumor with a peculiar infiltrative growth pattern resembling rabbit burrows (cuniculi). It usually occurs over the plantar aspect of the foot but can also occur at other sites like the oral cavity and genitals. The pathogenesis is unknown, with various hypotheses of trauma as proposed by different authors. It is essential to be aware of this entity as it commonly mimics benign and other low-grade squamous cell carcinoma (SCC). Diagnosis of CC can be challenging and requires repeated histological evaluation and clinical correlation. Herein, we present a case report of CC of the plantar and dorsal aspect of the foot in a 60-year-old male with a history of multiple chronic non-healing ulcers, which was clinically suspected as eumycetoma and remained inconclusive on numerous biopsies.

Traversing the Terrain: Potential Pitfalls within the AJCC 8th Edition Staging System for Lip and Oral Cavity Cancers.

In 1977, the American Joint Committee on Cancer (AJCC) introduced the inaugural Cancer Staging Manual, which implemented the T (tumor extent), N (regional lymph node status), and M (presence or absence of distant metastasis) staging system. This systematic approach aimed to convey the extent of disease across various cancer types, providing clinicians with a practical framework to plan treatment strategies, predict prognosis, and assess outcomes. The AJCC 8th edition, effective from January 1, 2018, continues this tradition. However, certain shortcomings persist in the AJCC 8th edition, as identified through clinical experience. Specifically, challenges arise in accurately assessing depth of invasion in unique histological variants of oral squamous cell carcinoma (e.g., Oral verrucous carcinoma, Carcinoma cuniculatum, and Papillary squamous cell carcinoma) and minor salivary gland tumors. Additionally, discrepancies exist in the perception of bone invasion patterns and in reporting practices. There is also a need for staging guidelines for malignant odontogenic tumors and multifocal tumors of the oral cavity, supplemented by diagrammatic representations. Lastly, there is a call for comprehensive staging criteria for carcinomas of the ear, external auditory canal, and temporal bone. We advocate for the inclusion of these considerations in future editions of the AJCC Cancer Staging Manual.

Histopathological Variants of Oral Squamous Cell Carcinoma Operated at a Cancer Institute in North India

Histopathological Variants of Oral Squamous Cell Carcinoma Operated at a Cancer Institute in North India

Multiple squamous cell carcinomas of temporal bone years after radiotherapy for malignancy glottis-report of a rare case with review of literature

Larynx is unique in its anatomy. It is critical to map the lesions accurately so that the patient may benefit from the strategy most likely to preserve a functional larynx with the lowest likelihood of recurrence and the least morbidity. We describe a case of 60-year-old male with malignancy glottis diagnosed at the age of 43, treated with external beam radiotherapy, presented 15 years after with swelling in the right upper part of the face, lateral to the eye. Radiological investigations suggested neoplasm in the skin over the right zygomatic part of the temporal bone. Biopsy confirmed malignancy, basal cell carcinoma type. Wide local excision of the lesion with split skin grafting was done. After 2 years, he presented with right ear pain, discharge, and hard of hearing. Examination and radiological investigations confirmed a mass in the external auditory canal, infiltrating through the temporal bone. Biopsy revealed an acantholytic variant of squamous cell carcinoma (SCC). The patient was advised about treatment options and radiotherapy was chosen. Further, a literature search was conducted to detect similar cases. We describe the incidence and prevalence of radiation-induced temporal bone malignancy, an exceedingly rare and late complication of head and neck irradiation. Radiation induced SCCs are highly malignant secondary neoplasms in the head and neck region. It constitutes a therapeutic challenge because of its anatomy and the known side effects of radiation. Timely intervention with a multidisciplinary approach is necessary.

Clear Cell Squamous Cell Carcinoma: A Rare Case Report

Clear cell squamous cell carcinoma (SCC) is a rare variant of SCC of skin in which ultraviolet radiation has been suggested as possible etiology. We report a case of A 35-year-old man who works as a farmer presenting with an ulcerative-burgeoning lesion of the face that had been evolving for 2 years. microscopic examination revealed a clear-cell squamous cell carcinoma. It is a rare entity that must be diagnosed with care. when evaluating lesions with predominantly clear cell morphology, histopathological diagnosis is often difficult. Further research is needed to understand the pathophysiology, biological behavior, therapeutic options and prognosis.

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.

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.

Gingival Carcinoma Cuniculatum: A Case Series of Seven Cases with Emphasis on Immunohistochemical and Histochemical Features.

Oral carcinoma cuniculatum (CC) is a rare distinct variant of oral squamous cell carcinoma (OSCC) displaying unique clinical and histopathological features. CC is a locally aggressive malignancy with lower metastatic potential and has a tendency to invade the underlying bone yielding nonspecific clinical presentation resembling fungal/bacterial infections or osteomyelitis. Seven rare cases of gingival CC are reported with special emphasis on immunohistochemistry and special stains. Clinical and demographic profile were analysed and all cases were subjected to Ki-67 and p53 immunostaining and Ayoub-Shklar histochemical staining. For comparison, age and gender matched seven cases of conventional OSCC with bony involvement were recruited. IBM SPSS statistics software version 26 (IBM Analytics, Armonk, New York, U.S.) was used to analyse the data. All cases of CC lacked p53 expression in contrast to OSCC and demonstrated intermediate to high proliferation index in stroma also. The keratin staining and cytokeratin profile in OSCC and CC were also found to be statistically different. CC is a rare well differentiated variant of OSCC with different pathways involved in the pathogenesis. Local aggressive and invasive nature could be the result of unique interaction between epithelium and stromal elements. Oral health care provider must be familiar with this uncommon variant of OSCC.

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.

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.