Cutaneous squamous cell carcinomas consistently show histologic evidence of in situ changes: A clinicopathologic correlation☆,☆☆,★
Section snippets
MATERIAL AND METHODS
In this study, we reviewed 1011 squamous cell carcinomas on sun-damaged skin retrieved from the files of Dermatopathology Laboratory, Inc, Indianapolis, Indiana, from July 1, 1996 to Nov 1, 1998. The lesions were obtained by excision or shave technique from 859 patients (572 men, 287 women); their ages ranged from 34 to 99 years (mean age, 75 years). The lesions were previously reviewed and diagnosed histopathologically by 3 dermatopathologists employed by the laboratory.
Initially, the lesions
RESULTS
Each of the 1011 previously diagnosed squamous cell carcinomas met the criteria for squamous cell carcinoma as defined previously. Further histopathologic examination showed that 983 of the 1011 specimens (97.2%) had changes consistent with squamous cell carcinoma in situ at the periphery or within the confines of the existing squamous cell carcinoma.
During our review, histologic evidence for the evolution of squamous cell carcinoma in situ into squamous cell carcinoma was clearly apparent.
DISCUSSION
The evolution of malignant neoplastic processes is well studied in all organ systems. However, there has been controversy related to the time a lesion should be considered malignant. In the field of dermatology, the evolution of squamous cell carcinoma, including its inception as squamous cell carcinoma in situ as a malignant process, has long been a firestorm of controversy. According to Leffell et al,1 actinic keratoses are the beginning of the cancer spectrum; the initial step in the process
References (16)
Histological study of vesical urothelium intervening between gross neoplasms in total cystectomy
J Urol
(1952)- et al.
Actinic Keratosis Conference, Washington, DC, January 27, 1999
Dermatol World
(1999) - et al.
p53-Binding proteins in squamous-cell carcinoma and normal human keratinocytes
Cell Growth Differ
(1995) The actinic keratosis: a perspective and update
Dermatol Surg
(1997)- et al.
Clues to diagnosis in dermatopathology
- et al.
The lives of lesions
- et al.
Questions to the editorial board and other authorities
Am J Dermatopathol
(1984) Tumors and cysts of the epidermis
Cited by (86)
The expression pattern and functional role of REIC/Dkk-3 in the development of cutaneous squamous cell carcinoma
2016, Journal of Dermatological ScienceCitation Excerpt :However, the exact physiological function of REIC/Dkk-3 remains unclear. Actinic keratosis (AK) and cutaneous squamous cell carcinoma (CSCC) represent a disease continuum of photodamaged skin because most CSCC arises from the pre-cancerous lesion-like AK [6,7]. Therefore, we measured REIC/Dkk-3 expression levels in the disease spectrum from AK through Bowens disease to CSCC and studied the functional role of REIC/Dkk-3 in the development of CSCC.
Squamous cell carcinoma
2015, Clinical Equine OncologySpanish adaptation of the european guidelines for the evaluation and treatment of actinic keratosis
2014, Actas Dermo-SifiliograficasCitation Excerpt :The phenomenon of field cancerization has important therapeutic implications that will be discussed below. AKs are characterized microscopically by proliferation of intraepidermal keratinocytic atypia (large pleomorphic and hyperchromatic nuclei) with loss of polarity and mitotic figures; these cells are similar to the keratinocytes in invasive SCCs and for this reason AKs are considered carcinomas in situ23–27 (level of evidence 4, grade D recommendation). These aberrations represent the first stage, characterized by keratinocytic atypia,1 of a clinical course that may progress to invasive SCC.
Actinic keratoses contiguous with squamous cell carcinomas are mostly non-hyperkeratotic and with severe dysplasia
2022, Journal of Clinical Pathology
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From the Dermatopathology Laboratory, Inc.
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Reprint requests: Robert M. Hurwitz, MD, Dermatopathology Laboratory, Inc, 9202 N Meridian St, Suite 215, Indianapolis, IN 46260.
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0190-9622/99/$8.00 + 0 16/1/98970