Squamous cell carcinoma-associated antigen in uroepithelial carcinoma.

We investigated the clinical significance of squamous cell carcinoma (SCC) antigen determined by radioimmunoassay on patients with uroepithelial carcinoma. Serum SCC antigen levels and the positive rates were significantly higher in uroepithelial carcinoma having an SCC component than in normal controls, benign urologic diseases, other urogenital carcinomas, or in pure transitional cell carcinoma (TCC) of uroepithelial carcinomas. A substantial number of patients with pure TCC showed a positive serum level of SCC antigen. Immunohistochemical staining of SCC antigen on the uroepithelial carcinomas confirmed that some, not all, pure TCC, mostly grade 3, expressed SCC antigen in their cells. These results suggested a biologic characteristic of grade 3 TCC which is closely related to that of SCC. The serum levels of SCC antigen correlated well with the disease extensions in uroepithelial carcinoma containing SCC component. Changes in serum levels of SCC antigen following treatment reflected the clinical courses of patients, particularly in those with elevated pretreatment levels. The results of our study indicated that the determination of SCC antigen would be clinically useful for monitoring clinical courses of patients with uroepithelial carcinomas containing SCC component and of those with pure TCC whose pretreatment level was elevated.     

Squamous cell carcinoma of the penis in a patient with chronic isolated penile lymphoedema

Squamous cell carcinoma arising in tissue affected by chronic lymphoedema is rare. We describe, to our knowledge, the first documented case of penile squamous cell carcinoma arising in a patient with a history of idiopathic chronic penile lymphoedema. Patients with chronic lymphoedema should be actively followed for possible malignant changes. We discuss the management and possible aetiology of this unusual case.     

Squamous cell carcinoma in a middle esophageal (parabronchial) diverticulum

The occurrence of carcinoma in an esophageal diverticulum is rare. Among the reported cases, carcinoma in the upper (pharyngoesophageal) diverticulum has the highest incidence, and a malignancy involving the middle (parabronchial) diverticulum is the least frequent. We now report the sixth case of carcinoma arising in the middle esophageal diverticulum after a 12 year follow-up. The importance of follow-up study of esophageal diverticulum is stressed.     

Clinical usage of the squamous cell carcinoma antigen in patients with penile cancer

BACKGROUND: We present our initial experience with the use of the squamous cell carcinoma (SCC) antigen (SCCAg) in 16 men with penile SCC (SCC group), in four men with condyloma acuminatum (benign group), and in 32 blood donors (control group). METHODS: The SCCAg levels were measured at presentation and every 6 months (upper limit was 2 ng/mL). The mean follow-up time was 4 years. RESULTS: All non-SCC patients had normal SSCAg serum levels in contrast with the SCC patients. The presence of nodal and/or distant metastases resulted in statistically significant higher SCCAg levels, both at presentation and during the follow-up. In patients undergoing lymph node dissection with elevated SCCAg levels prior to the procedure, there was a statistically significant decrease of the SCCAg levels after the operation. CONCLUSION: The SCCAg level could be a serum marker that holds promise for clinical use in penile SCC. Sequential monitoring of SCCAg level might indicate developing of nodal and/or distant metastases and could be useful in following the response to treatment.     

Squamous cell carcinoma of the penile skin in a neovagina 20 years after male-to-female reassignment.

We present a patient who underwent male-to-female reassignment, and then developed squamous cell carcinoma during a complicated long-term follow-up. In very rare cases, squamous cell carcinoma may be considered in the differential diagnosis of sustained ulceration in neovaginas constructed by inverting the penile skin in male-to-female reassignments, in particular because clinical examination may be hampered by contractile scar formation of the neovaginal canal. Despite the lack of statistical evidence, it may be assumed that the heterotopic penile skin is at an increased risk of developing HPV-induced squamous cell carcinoma, especially if, over the years, there is a personal history of venereal warts.     

Immunoexpression of p53 protein and proliferating cell nuclear antigen in penile carcinoma.

PURPOSE: We examined p53 protein and proliferating cell nuclear antigen immunoexpression as prognostic factors to the outcome of squamous cell carcinoma of the penis in 50 patients. MATERIALS AND METHODS: Penectomy and lymphadenectomy were performed in 14 patients with clinically positive nodes while 36 with cN0 disease were treated with penectomy and kept under surveillance that resulted in subsequent lymphadenectomy due to nodal relapse in 8. Of 21 patients with confirmed nodal metastases 18 died of disease. Immunohistochemical reactions were performed via the avidin-biotin-immunoperoxidase method and the results were compared with tumor pT stage, grade, nodal status and cause specific death. RESULTS: In univariate analysis proliferating cell nuclear antigen staining showed association only with nodal metastasis (p = 0.04) while p53 staining exhibited correlation with tumor pT stage (p = 0.0005), grade (p = 0.02), lymphatic spread (p = 0.02) and cause specific survival (p = 0.003). Multivariate analysis showed that p53 immunoreactivity was the only factor with prognostic significance for disease progression and cause specific survival. Tumor pT stage, grade and proliferating cell nuclear antigen staining had no significance for nodal metastases and cause specific death. CONCLUSIONS: Proliferating cell nuclear antigen staining had no prognostic value for disease progression. Since p53 over expression was associated with tumor progression and cause specific death, perhaps it should be evaluated in staging and therapeutic planning for patients with squamous cell carcinoma of the penis.     

Squamous cell carcinoma arising in a giant condyloma acuminatum (Buschke-Lowenstein tumour)

Giant condyloma acuminatum (GCA) is a tumour that primarily affects the genital and perianal areas. Despite the histologically benign appearance, it behaves in a malignant fashion, destroying adjacent tissues, and is regarded as an entity intermediate between an ordinary condyloma acuminatum and squamous cell carcinoma. Primary anorectal lesions account for only a small number of GCA cases and, as with squamous cell carcinoma, the human papilloma virus is the causative agent. The hallmark of GCA is the high rate of local recurrence and transformation into squamous cell carcinoma. We describe a case of GCA complicated by malignant transformation, where locoregional control was achieved with combined chemoradiotherapy.     

Squamous cell carcinoma in bladder extrophy

Bladder extrophy is a rare congenital malformation that nowadays is surgically corrected in neonatal period. We present a case report of a 71-year-old male with a verrucous squamous cell carcinoma arising in a classical uncorrected form of bladder extrophy.     

Squamous cell carcinoma in epidermolysis bullosa

Epidermolysis bullosa (EB) is a group of inherited blistering disorders that are divided into three categories based on the plane of cleavage of the blister, mode of inheritance, and the presence or absence of scars. Squamous cell carcinoma developing in epidermolysis bullosa is rare and presents a therapeutic dilemma. The authors report a case of congenital epidermolysis bullosa with locally advanced squamous cell carcinoma.     

Squamous cell carcinoma and meningomyelocele

A case of invasive squamous cell carcinoma arising in the skin overlying a large lumbar meningomyelocele is reported. This case is unique in that a chronic neurocutaneous fistula was not present. It is proposed that chronic irritation of the meningomyelocele was the primary factor in the pathogenesis of the cancer.     

Squamous cell carcinoma of scrotum

Squamous cell carcinoma of the scrotum is a rare malignancy in the United States. This series includes the eighth reported case of this lesion in a black American. Surgery still remains the only effective therapeutic modality. The use of sentinel and superficial inguinal node biopsies was important in determining whether or not radical ilioinguinal lymphadenectomy was needed in 2 patients.     

Squamous cell carcinoma of prostate

A primary squamous cell carcinoma occurring in the prostate of a sixty-nine-year-old man is described. A radical excision that included cystoprostatectomy, total penectomy, scrotectomy, pubic symphysiectomy, and abdominoperineal resection of rectum was done. The patient died of systemic metastases six months after diagnosis. Review of the literature suggests that such a cancer of the prostate is rare, highly aggressive, and responds poorly to any mode of therapy. Histogenesis of this tumor remains controversial; however, it probably does not originate from the prostatic acinar cells.     

Studies on antigen associated with human squamous cell carcinoma (SCC antigen) in patients with esophageal carcinoma

The authors studied on SCC antigen in patients with esophageal carcinoma. Serum SCC antigen was found in 9 (40.9%) of 22 patients with esophageal squamous cell carcinoma and 5 (55.5%) of 9 patients with lung squamous cell carcinoma, but was not found in other malignant diseases, such as gastric cancer, hepatoma, colon cancer, pancreas cancer and biliary try tract cancer. SCC antigen positive cases increased in association with progression of histological invasion, grade of nodal metastasis and clinical stage. However, in early esophageal carcinoma, SCC antigen was rarely positive. There was no positive case in patients with poorly differentiated squamous cell carcinoma regardless of clinical stage. Positive rate of SCC antigen increased in association with progression of clinical stage in patients with moderately and well differentiated squamous cell carcinoma. Immunoreactivity of SCC, which was investigated immunohistologically with TA-4 rabbit serum, was not found in cases with poorly differentiated squamous cell carcinoma, but was found in keratinized portion and cytoplasm of moderately and well differentiated carcinoma. From the above, SCC antigen is intimately related with keratinization of squamous cell carcinoma, and it was thought that it could be useful as a good marker for diagnosis of moderately and well differentiated squamous carcinoma of the esophagus.     

Squamous cell carcinoma of bladder

Examination of the histology of all bladder tumors presented to the London Hospital over a ten-year period revealed a surprisingly low incidence of squamous bladder carcinoma. We would support the view of other workers that this tumor usually presents at an advanced stage and carries with it a poor prognosis. However, when no evidence of metastatic disease is evident, treatment with standard protocol of radiation therapy and cystectomy should achieve the same results as for the transitional cell tumor. Squamous cell carcinoma of the bladder would appear to be as radiosensitive as its transitional cell counterpart.     

Squamous cell carcinoma and transitional cell carcinoma arising in bladder augmentations

Tumours arising in bowel-augmented bladders are rare. Usually these tumours are adenocarcinomas that occur along the anastomotic line. We present two unusual tumours, squamous cell carcinoma and transitional cell carcinoma, that occurred in bladder augmentations. We also emphasize the need for regular cystoscopic surveillance.