Squamous cell carcinoma arising in a ciliated hepatic foregut cyst: Case report and literature review

We report a case of squamous cell carcinoma arising in a ciliated hepatic foregut cyst (CHFC) in the left lobe of the liver in a 60-year-old woman. Gross examination revealed an irregular, partially encapsulated, smooth tumor mass with multiple cystic areas, 3–5 mm in size. Microscopically, the lining of the microcysts was composed of ciliated columnar epithelium with scattered goblet cells. Multiple foci of squamous metaplasia of the columnar epithelium were observed, which showed areas with dysplastic changes and other areas with carcinomatous transformation. Our case also showed an inconspicuous or absent smooth muscle layer. This case suggests that CHFC deserves careful clinical follow-up and differential diagnosis to exclude malignant transformation. Total surgical excision of the cyst is recommended.     

Squamous cell carcinoma originated from an epidermal cyst

Epidermal cyst (EC) of the skin is a very common condition. Squamous cell carcinoma (SCC) very infrequently arises from EC. A 76-year-old Japanese woman was admitted to our hospital because of multiple papules in the nose and nasal cavity. The clinical diagnosis was sebaceous hyperplasia. An excisional biopsy was obtained from one papule. Histologically, the papule showed an EC. The EC communicated with the epidermis. Islands of atypical cells with hyperchromatic nuclei and infrequent pearl formation were recognized around and adjacent to EC. No connections were seen between the atypical cell islands and epidermis. The atypical cells had hyperchromatic nuclei and nucleoli. Mitotic figures and keratinous pearls were scattered. The HE diagnosis was probable SCC probably arising from EC. Immunohistochemically, the atypical cells were positive for pancytokeratin AE1/3, cytokeratin (CK) 5/6, CK14, CK18, CK 34BE14, EMA, p53, Ki-67 (labeling 90%), and p63. They were negative for pancytokeratin CAM5.2, CK7, CK8, CK19, CK20, vimentin, S100 protein, HMB45, synaptophysin, and CD56. CD68 was positive in histiocytes and giant cells in the foreign body reaction. The EC showed the same immunoprofile as the SCC, except for negative p53 and low Ki-67 labeling in the EC. The histological and immunohistochemical diagnosis was definite SCC arising from EC.     

Squamous cell carcinoma arising within verrucous carcinoma of the oral cavity: a case report

The author herein reports a case of squamous cell carcinoma (SCC) arising within verrucous carcinoma (VC) of the hard palate. An 84-year-old woman was admitted to our hospital complaining of oral discomfort. Oral examination revealed a pedunculated verrucous tumor (15 x 15 mm) in the hard palate. A biopsy revealed verrucous tumor. Resection of the lesion with wide margins was performed. Grossly, the palate tumor was pedunculated and verrucous, but a depressed area (8 x 7 mm) was recognized. Microscopically, the verrucous ares showed verrucous proliferation of squamous epithelium with little cellular atypia, and was interpreted as VC without invasion. The depressed lesion was obvious SCC with invasion. There were direct transitions between the VC and SCC. Immunohistochemically, the VC and SCC tumor cells were negative for human papilloma virus antigens. P53 protein was expressed in both VC and SCC, though the expression in SCC was much more strong and broad than that in VC. The Ki-67 antigen was also expressed in the VC and SCC, and Ki-67 labeling index ranged was 12% in VC and 64% in SCC. These findings indicate that SCC may arise within VC.     

Transitional cell carcinoma arising in a pyelocaliceal cyst

 The differentiation between benign and malignant cystic lesions of the kidney is a diagnostic challenge. Medical imaging aids in this task, but many cystic renal lesions require further work-up, frequently by computed tomography-guided fine needle aspiration. We report on the pathological findings in a case of moderately differentiated papillary transitional carcinoma, which arose in a pre-existing pyelocaliceal cyst in a 53-year-old man. In the case of this lesion, the distinction between a benign and a malignant renal cyst is blurred. To our knowledge, this is the third such occurrence to be reported and the first to be diagnosed by fine needle aspiration biopsy. Received: 28 July 1998 / Accepted: 24 November 1998     

Squamous cell carcinoma arising from a seminal vesicular cyst: possible relationship between chronic inflammation and tumor development

A case of squamous cell carcinoma arising within an acquired seminal vesicular cyst is described. A 61-year-old man was hospitalized because of hemospermia and dysuria. Under the diagnosis of a left seminal vesicular cyst, surgical resection was performed. Pathological examination revealed squamous cell carcinoma within a seminal vesicular cyst, along with squamous metaplastic foci and severe chronic inflammation. Cell proliferation, determined with reference to MIB-1 labeling indices, showed a stepwise increase from normal columnar epithelium, through squamous metaplasia, to squamous cell carcinoma. Sporadic p53 protein accumulation without evident gene mutations was also apparent in both the carcinoma and squamous metaplastic lesions. We therefore concluded that the squamous cell carcinoma might have developed from squamous metaplastic foci associated with chronic inflammatory stimulation, within a seminal vesicular cyst.     

Squamous cell carcinoma arising in a ciliated hepatic foregut cyst

We report a case of squamous-cell carcinoma arising in a ciliated hepatic foregut cyst that occurred in a 21-year-old man. The cystic lesion was first discovered during childhood with no further follow-up. Following important weight loss over several months, the patient was admitted to our hospital where a CT scan showed a cystic and solid mass in segments V and VI of the liver involving the transverse mesocolon and the gastric antrum. A right hepatectomy with en-bloc right hemicolectomy and partial gastrectomy was performed. Gross examination showed a partially cystic liver mass with a maximum dimension of 10 cm infiltrating the large bowel wall. Microscopically, it was a poorly differentiated squamous-cell carcinoma arising from the wall of a liver cyst lined by a ciliated, pseudostratified columnar epithelium. Hepatic foregut cysts are uncommon, congenital, benign lesions that, when discovered, deserve careful clinical follow-up as malignant transformation, albeit exceptional, is possible.     

Ciliated hepatic foregut cyst with extensive squamous metaplasia: report of a case

Ciliated hepatic foregut cysts (CHFC) are rare cystic lesions of the liver composed of a ciliated pseudostratified columnar epithelium with mucous cells, connective tissue, and smooth muscles bundles. We report the first case of CHFC with extensive squamous metaplasia without dysplasia or carcinoma. A unilocular, avascular, hypoechoic 60-mm liver lesion located in segment IV was detected by ultrasonography in a 31-year-old woman. The cyst was surgically removed and was lined mainly by a regular squamous epithelium without keratin formation. After extensive sampling, a ciliated pseudostratified columnar epithelium with some alcian blue-positive goblet cells was identified. The lesion was totally examined and there was no epithelial dysplasia or carcinoma. Squamous epithelium is very rare in hepatic foregut cysts and may degenerate into squamous carcinoma. Squamous epithelium is also described in biliary cysts. When squamous epithelium is identified in a liver cyst, an extensive sampling is recommended to identify possible foci of squamous carcinoma and to classify more precisely the histological type of the lesion. Because some cases of squamous carcinoma have been described in CHFC, surgical removal of the lesion may be more appropriate than close follow-up or sclerosing therapy.     

Squamous cell carcinoma in a duplicate large intestine

Summary A case report of a squamous cell carcinoma arising in a closed duplication of the large intestine is presented. The aetiology of squamous cell carcinoma in this site is discussed. It is quite possible the epithelial changes described in this case are similar to those associated with squamous cell carcinoma in other anatomical sites. The unusual environment within the lumen of a closed duplication may be carcinogenic.     

Squamous cell carcinoma arising in a ciliated hepatic foregut cyst.

Ciliated hepatic foregut cysts are rare congenital lesions derived from the embryologic foregut. They are considered benign, and a review of 64 published cases revealed no instances of malignant transformation. We report a case of squamous cell carcinoma arising in a ciliated hepatic foregut cyst in a 51-year-old man. The tumor was found during a routine cholecystectomy and involved the adjacent mesentery and duodenal wall. There was histologic evidence of perineural and perivascular involvement. Despite an en bloc resection of the tumor and contiguous areas of gross involvement, the patient died 2 months later. Although aspiration of cyst contents is an accepted treatment for asymptomatic lesions, this case suggests that most ciliated hepatic foregut cysts should be excised, especially when radiologic studies yield equivocal results.     

Squamous cell carcinoma of the larynx in a Pekingese dog

This is a report of an unusual multicentric squamous cell carcinoma in the larynx of a Pekingese dog. A 5-year-old female Pekingese dog with a 1-month history of unexplained pain localized to an asymmetrical swelling of the neck together with lethargy and poor appetite was referred to the Veterinary Clinic of Shiraz University. Plain radiographs of the neck revealed ventral displacement of the trachea, with the space between the trachea and spine occupied by a soft tissue mass. Histopathology of the mass affirmed squamous cell carcinoma that affected the larynx. According to the history, clinical signs, radiology, necropsy findings, and histopathological examination, the case was diagnosed as laryngeal squamous cell carcinoma.     

Intestinal metastases in a squamous cell carcinoma arising in mature cystic teratoma of the ovary: a case report

Metastatic spread to the intestines by squamous cell carcinoma (SCC) arising in mature cystic teratoma (MCT) or dermoid cyst is a very rare event. A case of a 40-year-old cachectic woman is presented with an MCT of the left ovary found at autopsy. Focal mural thickening of the cyst wall harbored a moderately differentiated SCC with single cell keratinization. Intramural metastases were noted in the jejunum, ileum, colon transversum, and left colonic flexure. In addition, liver metastases were detected. The tumor was staged as FIGO IV. The peritoneum was covered diffusely by fibrinous and suppurative exudate. In this unusual case, metastasizing SCC of the ovary arising in an MCT led to suppurative peritonitis and consequently to death of the patient. Follow-up procedures regarding intestinal spread could be useful in patients with SCC in MCT.     

Basal cell carcinoma arising from a keratinous cyst of the skin: a case report and review of the literature

Although keratinous cysts of the skin are frequently seen, malignant transformation is a rare event. Here we report a case of basal cell carcinoma arising in the wall of the keratinous cyst, and we review 12 other such Japanese cases.     

Neuroendocrine carcinoma of the posterior mediastinum arising from a foregut cyst

Neuroendocrine carcinoma of the posterior mediastinum is extremely rare. Described here is a patient with neuroendocrine carcinoma of the posterior mediastinum arising from a foregut cyst. A paravertebral mass detected in the posterior mediastinum of a 64-year-old man was spherical, solid and yellowish white. Some cystic or cleft-like spaces were present. Microscopically, the lesion was composed of proliferating round or polygonal tumor cells in a diffuse, solid or trabecular fashion with extensive necrosis and high mitotic activity. Components of glandular epithelia and smooth muscle layers were evident in the cystic wall. Immunohistochemically, the tumor cells were positive for both epithelial and neuroendocrine markers, including pan-cytokeratin, chromogranin A and synaptophysin. Neuroendocrine marker-positive cells were also present in the glandular epithelium of the cystic walls. It was considered that posterior mediastinal neuroendocrine carcinoma arose from a foregut cyst. Malignant change within a foregut cyst is very uncommon. This is the first report of a neuroendocrine carcinoma of the posterior mediastinum arising from a foregut cyst.     

Thyroid papillary carcinoma arising in ectopic thyroid tissue within a branchial cleft cyst

A case of papillary carcinoma arising in ectopic thyroid tissue within a branchial cleft cyst is described. A 46-year-old woman presented with a 2.0 x 2.0 cm mass in her left lateral neck. The excised mass showed a cystic lesion with a thyroid papillary carcinoma. Following a lateral cervical cystectomy, subsequent thyroid gland and lymph nodes dissections were performed. Pathological examination showed an adenomatous goiter and no primary carcinoma in the thyroid gland, as well as metastatic papillary carcinoma in the lymph nodes. Two cases of thyroid papillary carcinoma arising in ectopic thyroid tissue within a branchial cyst have been reported previously, but no lymph node metastases were recognized. The first case of papillary carcinoma arising in ectopic thyroid tissue within a branchial cleft cyst, and accompanied by lymph node metastasis is presented.