Basaloid squamous cell carcinoma of the head and neck

PURPOSE OF REVIEW: Basaloid squamous cell carcinoma is an uncommon variant of squamous cell carcinoma and was first described as a distinct entity in 1986. Basaloid squamous cell carcinoma seems to have a poorer survival rate than classical squamous cell carcinoma. On the basis of a critical literature survey, we attempt to evaluate if basaloid squamous cell carcinoma is really more aggressive and presents a poorer outcome than squamous cell carcinoma. RECENT FINDINGS: All papers are retrospective, and most include small numbers of cases, which are further diminished when subdivided according to specific sites. Only in three studies was basaloid squamous cell carcinoma of the head and neck region compared with matched squamous cell carcinoma controls. These studies did not show a uniform tendency regarding the aggressiveness and outcome of basaloid squamous cell carcinoma. In addition, several recent papers confirmed the presumed greater aggressiveness and worse outcome, and other recent papers questioned these characteristics. SUMMARY: The presented literature survey does not permit conclusions regarding the aggressiveness and outcome of basaloid squamous cell carcinoma compared with squamous cell carcinoma. Greater numbers of basaloid squamous cell carcinoma should be studied and compared with site-matched, stage-matched, and age-matched controls of conventional squamous cell carcinoma.     

Case report of a basaloid squamous epithelial carcinoma of the oropharynx: clinical and histopathologic markers of an aggressive tumor entity]

BACKGROUND: Basaloid squamous cell carcinoma is a variant of squamous cell carcinoma which is located predominantly in the upper aerodigestive tract. The cardinal histopathologic feature is a biphasic cellular pattern of basaloid and squamous components in a close relationship. Major differential diagnoses include adenoid cystic, adeno, squamous, adenosquamous, and basal cell carcinomas. This entity may commonly pose diagnostic difficulties, especially on small biopsy material, if only the basaloid component of the tumor is included. CASE REPORT: A tumor of the oropharynx (T2) was detected in a 61-year-old man. After endoscopic biopsy, this tumor was histologically identified as an adenocarcinoma. A very rapid tumor growth became obvious during the patient's staging. After pharyngectomy and neck dissection, the histopathological diagnosis was corrected to a basaloid squamous cell carcinoma. The definite diagnosis was not made on biopsy material, because only the basaloid component of the tumor was included. DISCUSSION: Basaloid squamous carcinoma is a biologically aggressive tumor with high proliferative activity and a propensity to destructive local growth and early regional and distant metastasis. Literature predominantly indicates that basaloid squamous cell carcinoma is an aggressive variant of squamous cell carcinoma and is prognostically worse than the regular squamous cell carcinoma. CONCLUSION: Because of the aggressive biological behavior of basaloid squamous cell carcinoma, radical surgery combined with radiation and chemotherapy is the treatment of choice.     

Adenocarcinoma of the para-nasal sinuses.

1. Adenocarcinoma in this series is commoner than squamous cell carcinoma. 2. Adenocarcinoma is a disease mainly affecting the ethmoid sinuses whereas squamous cell carcinoma is a disease mainly affecting the maxillary sinuses. 3. Patients with adenocarcinoma survive longer than those with squamous cell carcinoma. 4. Death from adenocarcinoma usually results from intra-cranial infiltration and therefore widespread resection with the assistance of a neuro-surgeon may be needed.     

Evaluation of p53, p63, p21, p27, ki-67 in paranasal sinus squamous cell carcinoma and inverted papilloma

Using a molecular genetic approach, we try to confirm the molecular alterations of inverted papilloma and clarify its status as a putative precursor lesion of sinonasal squamous cell carcinoma. To better understand its genetics, we investigated the immunohistochemical protein expression patterns of cell-cycle-regulators p53, p63, p21, p27 and proliferation marker Ki-67 in 22 inverted papilloma and 9 squamous cell carcinoma of the sinonasal tract. Significantly elevated levels of p53 and p63 in squamous cell carcinoma of sinonasal tract compared with inverted papilloma were revealed. Ki-67-stained neoplastic cell nuclei were found in a significantly higher percentage of squamous cell carcinoma of sinonasal tract than in inverted papilloma, whereas no variation of p21 and p27 expression was identified. This work first examined the immunohistochemical overexpression of p63 in sinonasal inverted papilloma and squamous cell carcinoma. In conclusion, this is a first study shedding light on the expression of p63 in tumors of paranasal sinuses.     

咽喉部鳞状细胞癌细胞系

咽喉部鳞状细胞癌是头颈外科常见恶性肿瘤,头颈部解剖结构复杂,原发部位不同的鳞状细胞癌发病率、诊疗方案不同,其发生的分子机制也可能存在差异。因此,选择适合的咽喉部鳞状细胞癌细胞系对于研究者选择适合的临床前研究模型,以及更好地理解肿瘤发生发展机制具有重要意义。总结了鼻咽、口咽、喉咽、喉四个解剖部位的鳞状细胞癌细胞系,以望对研究者选择适当的细胞系作为研究对象提供参考。     

Immunohistochemical study of dysplasia and squamous cell carcinoma of the larynx

Formalin- or alcohol-fixed, paraffin-embedded laryngeal specimens were stained immunohistochemically with several kinds of monoclonal anti-Keratin antibody (KL-1, PKK-1, PKK-2, PKK-3), polyclonal anti-Keratin antibody, and epithelial membrane antigen. Immunohistochemical technique was used by Avidin-Biotin Complex method with the following subjects; normal epithelium 6 cases, dysplasia 15 cases, inflammation and polyp 12 cases, squamous cell carcinoma 47 cases. 6 specimens of squamous cell carcinoma were totally resected and alcohol-fixed, and other specimens were all biopsied and formalin-fixed. Comparing these two methods, the alcohol-fixed specimen gave superior result to those obtained with formalin-fixed in its staining. Non-staining area was recognized around basal layer by KL-1 stain in the normal epithelium. Enlargement of non-staining area was recognized in the dysplasia. Also, KL-1 staining showed positive staining with the keratinizing squamous cell carcinoma, and weak staining with the non-keratinizing squamous cell carcinoma. And, PKK-3 showed weak staining in the keratinizing squamous cell carcinoma. The results indicate that high molecular weight keratin (56 kilodalton) hardly localize around the basal layer in the squamous epithelium, and also in the non-keratinizing squamous cell carcinoma. The other way, this also suggests that low molecular weight keratin (45 kilodalton) hardly localize in the keratinizing squamous cell carcinoma. It is supposed that intracellular localization of keratin of dysplastic epithelium and squamous cell carcinoma varies from that in the normal squamous epithelium. Accordingly, monoclonal keratin stain is thought to be an useful method for the diagnosis of dysplasia and squamous cell carcinoma.     

Basaloid squamous cell carcinoma - larynx

Basaloid squamous cell carcinoma is a rare variant of squamous cell carcinoma, Larynx has been an uncommon site of this tumour which is said to have aggressive biological behaviour with high incidence of cervical and distant metastasis along with second primary. Two cases of laryngeal basaloid squamous cell carcinoma are reported with relevant review of literature. The submucosal spread of tumour is highlighted alongwith role of preoperative radio therapy.     

Poorly differentiated plasmacytoid squamous cell carcinoma: Case report of a rare malignancy

Plasmacytoid squamous cell carcinoma is an especially aggressive variant of squamous cell carcinoma that has previously been described in the literature as a variant of oral cancers and most extensively, in vulvular [3], transitional cell, and urothelial carcinomas [2,13,15–20]. In this case report, we present a 36-year-old man with 6 to 8?weeks of a progressively enlarging mass over the lateral third of his clavicle, acromion process, and deltoid. The mass was resected, and the supraclavicular defect was reconstructed using an anterolateral thigh free flap. Final pathology determined the specimen was an invasive poorly differentiated squamous cell carcinoma with spindle cell and plasmacytoid features of cutaneous origin. Plasmacytoid squamous cell carcinomas have previously been described in the oral cavity, but in no other subsite of the head and neck. This article describes the patient's case and provides a literature review of the available reports related to plasmacytoid variant of squamous cell carcinoma.     

多重癌的临床分析

目的探讨先证舌鳞状上皮癌(简称鳞癌)多重癌的临床特点和预后。方法中山大学肿瘤防治中心头颈科1992年1月～2001年12月收治580例舌鳞癌患者中,48例多重癌,其中先证舌鳞癌19例,回顾分析其临床和随访资料,探讨其临床特点和预后;Kaplan- Meier方法计算累积生存率。结果全组患者总的3年、5年生存率分别为30.3%、20.2%;第二原发癌19例包括口腔鳞癌9例(舌癌5例、软腭癌2例,口底和牙龈癌各1例)、食管鳞癌4例(其中发生在颈段1例)、肺癌3例,腮腺腺癌、喉鳞癌和乳腺腺癌各1例。两癌发生的中位时间间隔为78个月(范围:6～132个月)。结论舌鳞癌多重癌占全部舌鳞癌患者的8.1%,其中39.5%为先证舌鳞癌;第二原发癌63.1%发生在头颈部,该类患者预后较差,故加强舌鳞癌患者的随访及时发现第二原发癌甚为重要。     

Primary squamous cell carcinoma of the parotid gland: a case report with electron microscopic findings

Primary squamous cell carcinoma of the parotid gland is a rare tumor. Histological and ultrastructural features of a primary squamous cell carcinoma arising in the right parotid gland is presented. Light microscopically the tumor consisted of poorly differentiated squamous cell nests. PAS reaction was negative. Ultrastructurally the tumor cells were oval or spindle shaped and the cytoplasmic processes were frequently found. The majority of the tumor cells contained numerous intermediate filaments in their cytoplasm. No secretory granule was found. The desmosomes were well developed. It is known that mucoepidermoid carcinoma may be often misdiagnosed as squamous cell carcinoma. These findings can enable us to distinguish primary squamous cell carcinoma from mucoepidermoid carcinoma of the parotid gland.     

The lack of utility of a tumor marker panel in head and neck carcinoma. Squamous cell carcinoma antigen, carcinoembryonic antigen, lipid-associated sialic acid, and CA-125.

An ideal tumor marker should be sensitive in tumor-bearing patients while having adequate specificity so that controls do not demonstrate the marker. To date, a single circulating marker has not been identified for squamous cell carcinoma of the head and neck. This study evaluates a panel including squamous cell carcinoma radioimmunoassay, lipid-associated sialic acid, carcinoembryonic antigen, and CA-125. In this population of patients with cancer, serum samples from 101 patients and 88 controls were evaluated. The squamous cell carcinoma radioimmunoassay was the most sensitive marker identified (47.5%), while carcinoembryonic antigen level was elevated in 40.6%, lipid-associated sialic acid level in only 16.8%, and CA-125 level in 7.9%. False-positive results were found with all markers, including squamous cell carcinoma radioimmunoassay (18.2%), carcinoembryonic antigen (18.2%), lipid-associated sialic acid (10.2%), and CA-125 (15.9%). Various combinations of markers did not significantly improve either specificity or sensitivity. Available tumor markers are inadequate for diagnostic purposes in patients with squamous cell carcinoma of the head and neck.     

Basaloid squamous cell carcinoma of the external auditory canal: case report

Basaloid squamous cell carcinoma (BSCC) is a rare malignancy, with features of both basal cell carcinoma and squamous cell carcinoma. The tumor has a predilection for the upper aerodigestive tract, and has been suggested to behave more aggressively than squamous cell carcinoma (SCC). To the author’s knowledge, BSCC confined to the external auditory canal (EAC) has not been previously described. BSCC of EAC manifests similar characteristics as the conventional EAC cancer, presenting a mass with chronic otorrhea and itching sense. Excision of the tumor was accomplished by modified lateral temporal bone resection. This report describes the first case of BSCC in this location, and includes reviews of the pathologic and clinical aspects of this disease.     

K-ras基因在人喉鳞状细胞癌细胞株 Hep-2中的表达及其意义

目的：探讨K—ras基因在喉鳞状细胞癌细胞株Hep-2中的表达及其意义,为喉癌的发生与K-ras点突变的相关性研究奠定基础。方法：采用RT—PCR技术检测K—ras基因mRNA在喉癌细胞株Hep-2和胰腺癌细胞株MIAPaCa-2中的表达。结果：人胰腺癌细胞株MIAPaCa-2和人喉鳞状细胞癌细胞株HeP-2中K—ras mRNA表达均为强阳性。结论：人喉鳞状细胞癌细胞株Hep-2中K—ras基因表达阳性,喉癌的发生可能与其点突变引起的激活有关。     

Collision tumor of apocrine carcinoma and squamous carcinoma occurring in the ear

An unusual case of a cutaneous collision tumor comprised of a squamous cell carcinoma and an apocrine carcinoma occurring in the auricle of an 82-year-old man is presented. Microscopic study confirmed 2 distinct tumors: a squamous cell carcinoma arising in the epidermis and an adjacent apocrine carcinoma. We discuss the diagnostic criteria and review pertinent recent literature. To our knowledge, this is the first English language report of such a collision tumor.     

Invasive squamous cell carcinoma within verrucous carcinoma

A case of invasive squamous cell carcinoma within a verrucous carcinoma is presented in order to illustrate the potential problem of underdiagnosis of these lesions. The epidemiology, natural history and histopathology of verrucous carcinoma, and features which distinguish it from invasive squamous cell carcinoma, are reviewed. Unless rigorous attention is paid to histologic detail, a focus of invasive squamous cell carcinoma may escape detection and radiation-induced anaplastic transformation may later be suspected.     

A study of a new tumour marker,CYFRA 21-1, in squamous cell carcinoma of the head and neck,and comparison with squamous cell carcinoma antigen

CYFRA 21-1 (CYFRA) is a newly developed tumour marker which is useful in evaluating large cell lung carcinoma, especially the squamous cell type. The purpose of this study was to assess the clinical value of CYFRA for squamous cell carcinoma of the head and neck and compare the results with squamous cell carcinoma antigen (SCCA). Serum levels of CYFRA were measured in 168 patients with a newly diagnosed head and neck squamous carcinoma. In addition, 77 patients without evidence of neoplasm were included as controls. At the same time, SCCA was also determined. The cut-off values of CYFRA and SCCA, determined at the 95th percentile of the standard Gaussian variate of controls, were 2.48 ng/ml and 1.49 ng/ml respectively. The diagnostic sensitivity of CYFRA was superior to that of SCCA, especially for nasopharyngeal carcinoma. The sensitivity of CYFRA for nasopharyngeal carcinoma was much higher (58.3%) than that of SCCA (15.5%). However, the sensitivity of CYFRA is not satisfactory in all types of squamous carcinoma. For oral cancer, the sensitivity is only 25.6%. CYFRA is a useful serum marker for patients with certain types of head and neck squamous carcinoma, such as nasopharyngeal carcinoma and hypopharyngeal carcinoma. In addition, CYFRA may be also useful in monitoring recurrence of certain types of SCCHN, which are sometimes difficult to detect.     

Mixed squamous cell carcinoma and follicular carcinoma of the thyroid gland

Primary squamous cell carcinoma of the thyroid gland (PSCCT) is rare and its aetiology is debated. A 67-year-old man presented with neck mass. Fine-needle-aspiration (FNA) cytology and through-cut biopsy were suggestive of poorly differentiated or anaplastic carcinoma. The patient was offered tracheostomy and palliative cure for unresectable tumor of the thyroid; he refused and decided for other opinion. Lobe-isthmusectomy was performed with diagnostic and debulking intent. Final pathology report was of mixed squamous cell and follicular carcinoma of the thyroid. The tumor was a PSCCT. The patient underwent adjuvant chemoradiotherapy. After 2 years, an iliac crest metastasis of follicular carcinoma was diagnosed. The patient is disease free, after surgery and radio-active-iodine treatment. The hypothesis of squamous cell carcinoma transformation from well differentiated thyroid cancer has to be considered in case of PSCCT. Primary squamous cell carcinoma of the thyroid gland (PSCCT) is rare [1-3]; different theories on its aetiology do exist [4-6]. Mixed squamous cell and follicular carcinoma is even more rare than pure squamous cell of the thyroid gland and only few cases are reported in literature [7]. Preoperative diagnosis can be very challenging and the differential diagnosis with secondary squamous cell carcinoma of the thyroid (SSCCT) is manadatory in order to plan a correct management of the disease. The presence of PSCCT with distant metastasis of follicular carcinoma supports the histogenesis of squamous cell carcinomas arising from follicular epithelial cells.     

喉癌组织中热休克蛋白和人乳头状瘤病毒的相关性

目的 探讨喉鳞状细胞癌（简称喉癌）组织中热休克蛋白70（heat shock protein 70,HSP70）和人乳头状瘤病毒1 6E7（human papiloma-virus 1 6E7,HPV16E7）蛋白的表达及其在喉癌发生和发展过程中的相互关系.方法 用免疫组织化学方法检测78例喉癌、24例声带息肉和10例癌周喉组织标本中HSP70和HPV16E7蛋白的表达.结果 在喉癌组织、声带息肉和癌周喉组织中HSP70的阳性表达率分别为69.2%,8.3%和0%,HPV16E7蛋白的阳性表达率分别为43.6%,4.2%和0%,HSP70和HPV16E7蛋白的阳性表达在喉癌组织与声带息肉、癌周喉组织之间均有显著性差异（P＜0.05）;HPV16E7阳性的喉癌组织中HSP70的阳性表达率为85.3%,HPV16E7阴性的喉癌组织中HSP70的阳性表达率为56.8%,二者之间有显著性差异（P＜0.05）.结论 HPV16E7可以诱导喉癌组织中HSP70的高表达,二者在喉癌的发生和发展过程中发挥重要作用;检测HSP70和HPV16E7蛋白的表达可用于喉癌恶性程度的评定.     

Verrucous carcinoma of the nasal cavity: a case report

We report a rare case of verrucous carcinoma occurring in the nasal cavity. A 53-year-old man reporting left-sided nasal obstruction and awareness of a left intranasal lesion--a whitish polypoid lesion--was found in CT to have an expansive lesion of the left nasal cavity and maxillary sinus. The tumor was completely removed by Denker's operation. Verrucous carcinoma is a rare variant of squamous cell carcinoma most commonly seen in the oral cavity. In some cases, conventional squamous cell carcinoma components may be observed focally in verrucous carcinoma, called a hybrid tumor. In our case, the tumor showed typical features of a hybrid tumor. To the best of our knowledge, this is the first case of hybrid verrucous squamous cell carcinoma originating in the nose in the Japanese literature.