In medicine, squamous cell carcinoma (SCC) is a form of cancer of the carcinoma type that may occur in many different organs, including the skin, lips, mouth, esophagus, urinary bladder, prostate, lungs, vagina, and cervix. It is a malignant tumor of squamous epithelium (epithelium that shows squamous cell differentiation).

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Terminology

A large squamous cell carcinoma of the tongue.

Sites

Skin

Squamous cell carcinoma is the second most common cancer of the skin (after basal cell carcinoma but more common than melanoma). It usually occurs in areas exposed to the sun, and can generally be treated by excision only. Sunlight exposure and immunosuppression are risk factors for SCC of the skin. The risk of metastasis is larger than with basal cell carcinoma.

Head and neck cancer

Biopsy of a highly differentiated squamous cell carcinoma of the mouth. Haematoxylin & eosin stain.

Esophagus

Esophageal cancer may be due to either squamous cell carcinoma (ESCC) or adenocarcinoma (EAC). SCCs tend to occur closer to the mouth, while adenocarcinomas occur closer to the stomach. Dysphagia (difficulty swallowing, solids worse than liquids) and odynophagia are common initial symptoms. If the disease is localized, esophagectomy may offer the possibility of a cure. If the disease has spread, chemotherapy and radiotherapy are commonly used.

Lung

Photograph of a squamous cell carcinoma. Tumour is on the left, obstructing the bronchus (lung). Beyond the tumour the bronchus is inflammed and contains mucus.

When associated with the lung, it often causes ectopic production of parathyroid hormone-related protein (PTHrP), resulting in hypercalcemia.

Prostate

When associated with the prostate, squamous cell carcinoma is very aggressive in nature. It is difficult to detect as there is no increase in prostate specific antigen levels seen; meaning that the cancer is often diagnosed at an advanced stage.

Vagina and cervix

Vaginal squamous cell carcinoma spreads slowly and usually stays near the vagina, but may spread to the lungs and liver. This is the most common type of vaginal cancer.

Experimental treatments

In 2007, Australian biopharmaceutical company Clinuvel Pharmaceuticals Limited began clinical trials with a melanocyte-stimulating hormone called melanotan (known by the International Nonproprietary Name afamelanotide, formerly CUV1647)^[1] to provide photoprotection for organ transplant patients against squamous cell carcinoma of the skin and actinic keratosis.^[2][3]

Related conditions

• Keratoacanthoma is a low-grade malignancy of the skin. It originates in the pilo-sebaceous glands, and is similar in clinical presentation and microscopic analysis to squamous cell carcinoma, except that it contains a central keratin plug. Statistically, it is less likely to become invasive than squamous cell carcinoma.
• Bowen's disease is a sunlight-induced skin disease, and is considered to be an early form of squamous cell carcinoma.
• Marjolin's ulcer is a type of squamous cell carcinoma that arises from a non-healing ulcer or burn wound.

External links

• Information on Squamous Cell Carcinoma from The Skin Cancer Foundation
• Article by Stephen D Hess, MD, PhD
• DermNet NZ: Squamous cell carcinoma
• Squamous cell carcinoma in transplant recipients
• Including TCC, CIS and papillary tumour SCC

Notes and references

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