Difference between revisions of "Anal squamous cell carcinoma"

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#redirect [[Anus#Anal squamous cell carcinoma]]
{{ Infobox diagnosis
| Name      = {{PAGENAME}}
| Image      = Anus SquamousCellCarcinoma SCC NonKeratinizing AIA SCCIS CTR.jpg
| Width      =
| Caption    = Anal squamous cell carcinoma. [[H&E stain]].
| Synonyms  =
| Micro      =
| Subtypes  =
| LMDDx      = [[anal intraepithelial neoplasia]], poorly differentiated [[rectal adenocarcinoma]], [[anal gland adenocarcinoma]]
| Stains    =
| IHC        = p16 +ve
| EM        =
| Molecular  = HPV +ve
| IF        =
| Gross      =
| Grossing  =
| Site      = [[anus]]
| Assdx      =
| Syndromes  =
| Clinicalhx = +/-men who have sex with men, +/-immunodeficiency or immunosuppression
| Signs      =
| Symptoms  =
| Prevalence = most common anal cancer, overall uncommon
| Bloodwork  =
| Rads      =
| Endoscopy  =
| Prognosis  =
| Other      =
| ClinDDx    =
| Tx        = surgical excision
}}
'''Anal squamous cell carcinoma''' is the most common type of [[anal cancer]].<ref name=pmid25741135>{{Cite journal  | last1 = Ghosn | first1 = M. | last2 = Kourie | first2 = HR. | last3 = Abdayem | first3 = P. | last4 = Antoun | first4 = J. | last5 = Nasr | first5 = D. | title = Anal cancer treatment: Current status and future perspectives. | journal = World J Gastroenterol | volume = 21 | issue = 8 | pages = 2294-2302 | month = Feb | year = 2015 | doi = 10.3748/wjg.v21.i8.2294 | PMID = 25741135 }}</ref>


It is also known as '''anal squamous carcinoma''' and '''squamous cell carcinoma of the anus'''.
==General==
*Most common form of anal cancer.<ref name=pmid25741135/>
*Overall anal cancer uncommon.<ref name=pmid25741135/>
*Strong association with [[HPV]].<ref name=pmid23616200>{{Cite journal  | last1 = Cornall | first1 = AM. | last2 = Roberts | first2 = JM. | last3 = Garland | first3 = SM. | last4 = Hillman | first4 = RJ. | last5 = Grulich | first5 = AE. | last6 = Tabrizi | first6 = SN. | title = Anal and perianal squamous carcinomas and high-grade intraepithelial lesions exclusively associated with "low-risk" HPV genotypes 6 and 11. | journal = Int J Cancer | volume = 133 | issue = 9 | pages = 2253-8 | month = Nov | year = 2013 | doi = 10.1002/ijc.28228 | PMID = 23616200 }}</ref>
Risk factors:<ref name=pmid23806153>{{Cite journal  | last1 = Kutlubay | first1 = Z. | last2 = Engin | first2 = B. | last3 = Zara | first3 = T. | last4 = Tüzün | first4 = Y. | title = Anogenital malignancies and premalignancies: Facts and controversies. | journal = Clin Dermatol | volume = 31 | issue = 4 | pages = 362-73 | month =  | year =  | doi = 10.1016/j.clindermatol.2013.01.003 | PMID = 23806153 }}</ref>
*Men who have sex with men.
*Immunosuppressed.
*[[HIV]] infection.
==Microscopic==
Features:
*See ''[[squamous cell carcinoma]]''.
DDx:
*[[Anal intraepithelial neoplasia]].
*Rectal squamous cell carcinoma.<ref name=pmid17661147>{{Cite journal  | last1 = Nahas | first1 = CS. | last2 = Shia | first2 = J. | last3 = Joseph | first3 = R. | last4 = Schrag | first4 = D. | last5 = Minsky | first5 = BD. | last6 = Weiser | first6 = MR. | last7 = Guillem | first7 = JG. | last8 = Paty | first8 = PB. | last9 = Klimstra | first9 = DS. | title = Squamous-cell carcinoma of the rectum: a rare but curable tumor. | journal = Dis Colon Rectum | volume = 50 | issue = 9 | pages = 1393-400 | month = Sep | year = 2007 | doi = 10.1007/s10350-007-0256-z | PMID = 17661147 }}</ref>
*Poorly differentiated [[rectal adenocarcinoma]].
*[[Anal gland adenocarcinoma]].
===Images===
<gallery>
Image:Anus SquamousCellCarcinoma SCC NonKeratinizing AIA SCCIS CTR.jpg|Anus Squamous Cell Carcinoma (Non Keratinizing) - (SKB)
Image:Anus SquamousCellCarcinoma SCC NonKeratinizing MP CTR.jpg|Anus Squamous Cell Carcinoma (Non Keratinizing) - (SKB)
Image:Anus SquamousCellCarcinoma SCC NonKeratinizing MP4 CTR.jpg|Anus Squamous Cell Carcinoma (Non Keratinizing or shall we say poorly keratinizing as there are squamatized nests focally at high power) - (SKB)
</gallery>
==IHC==
*p16 +ve.<ref name=pmid23105122/>
*CDX2 -ve/+ve.
**May be useful to differentiate from [[vulva]] and [[penis]].<ref name=pmid23105122>{{Cite journal  | last1 = Gunia | first1 = S. | last2 = Koch | first2 = S. | last3 = May | first3 = M. | title = Is CDX2 immunostaining useful for delineating anorectal from penile/vulvar squamous cancer in the setting of squamous cell carcinoma with clinically unknown primary site presenting with histologically confirmed inguinal lymph node metastasis? | journal = J Clin Pathol | volume = 66 | issue = 2 | pages = 109-12 | month = Feb | year = 2013 | doi = 10.1136/jclinpath-2012-201138 | PMID = 23105122 }}</ref>
*PD-L1 +ve in ~40% of cases.<ref name=pmid34790403>{{cite journal |authors=Armstrong SA, Malley R, Wang H, Lenz HJ, Arguello D, El-Deiry WS, Xiu J, Gatalica Z, Hwang JJ, Philip PA, Shields AF, Marshall JL, Salem ME, Weinberg BA |title=Molecular characterization of squamous cell carcinoma of the anal canal |journal=J Gastrointest Oncol |volume=12 |issue=5 |pages=2423–2437 |date=October 2021 |pmid=34790403 |pmc=8576238 |doi=10.21037/jgo-20-610 |url=}}</ref>
**PD-1 expressed in nearly 70% of tumours.<ref name=pmid34790403/>
==Sign out==
<pre>
RECTUM, DISTAL, BIOPSY:
- INVASIVE SQUAMOUS CELL CARCINOMA.
</pre>
Notes:
*There is no CAP Cancer Protocol Template.
*AJCC staging is based on size of the tumour.<ref>URL: [https://www.cancer.org/cancer/types/anal-cancer/detection-diagnosis-staging/staging.html https://www.cancer.org/cancer/types/anal-cancer/detection-diagnosis-staging/staging.html]. Accessed on: June 26, 2023.</ref>
==See also==
*[[Anus]].
==References==
{{Reflist|2}}
[[Category:Diagnosis]]
[[Category:Diagnosis]]
[[Category:Anus]]

Latest revision as of 16:25, 26 June 2023

Anal squamous cell carcinoma
Diagnosis in short

Anal squamous cell carcinoma. H&E stain.
LM DDx anal intraepithelial neoplasia, poorly differentiated rectal adenocarcinoma, anal gland adenocarcinoma
IHC p16 +ve
Molecular HPV +ve
Site anus
Clinical history +/-men who have sex with men, +/-immunodeficiency or immunosuppression
Prevalence most common anal cancer, overall uncommon
Treatment surgical excision

Anal squamous cell carcinoma is the most common type of anal cancer.[1]

It is also known as anal squamous carcinoma and squamous cell carcinoma of the anus.

General

  • Most common form of anal cancer.[1]
  • Overall anal cancer uncommon.[1]
  • Strong association with HPV.[2]

Risk factors:[3]

  • Men who have sex with men.
  • Immunosuppressed.
  • HIV infection.

Microscopic

Features:

DDx:

Images

  • Anus Squamous Cell Carcinoma (Non Keratinizing) - (SKB)

  • Anus Squamous Cell Carcinoma (Non Keratinizing) - (SKB)

  • Anus Squamous Cell Carcinoma (Non Keratinizing or shall we say poorly keratinizing as there are squamatized nests focally at high power) - (SKB)

IHC

  • p16 +ve.[5]
  • CDX2 -ve/+ve.
  • PD-L1 +ve in ~40% of cases.[6]
    • PD-1 expressed in nearly 70% of tumours.[6]

Sign out

RECTUM, DISTAL, BIOPSY:
- INVASIVE SQUAMOUS CELL CARCINOMA.

Notes:

  • There is no CAP Cancer Protocol Template.
  • AJCC staging is based on size of the tumour.[7]

See also

References

  1. ↑ 1.0 1.1 1.2 Ghosn, M.; Kourie, HR.; Abdayem, P.; Antoun, J.; Nasr, D. (Feb 2015). "Anal cancer treatment: Current status and future perspectives.". World J Gastroenterol 21 (8): 2294-2302. doi:10.3748/wjg.v21.i8.2294. PMID 25741135.
  2. ↑ Cornall, AM.; Roberts, JM.; Garland, SM.; Hillman, RJ.; Grulich, AE.; Tabrizi, SN. (Nov 2013). "Anal and perianal squamous carcinomas and high-grade intraepithelial lesions exclusively associated with "low-risk" HPV genotypes 6 and 11.". Int J Cancer 133 (9): 2253-8. doi:10.1002/ijc.28228. PMID 23616200.
  3. ↑ Kutlubay, Z.; Engin, B.; Zara, T.; Tüzün, Y.. "Anogenital malignancies and premalignancies: Facts and controversies.". Clin Dermatol 31 (4): 362-73. doi:10.1016/j.clindermatol.2013.01.003. PMID 23806153.
  4. ↑ Nahas, CS.; Shia, J.; Joseph, R.; Schrag, D.; Minsky, BD.; Weiser, MR.; Guillem, JG.; Paty, PB. et al. (Sep 2007). "Squamous-cell carcinoma of the rectum: a rare but curable tumor.". Dis Colon Rectum 50 (9): 1393-400. doi:10.1007/s10350-007-0256-z. PMID 17661147.
  5. ↑ 5.0 5.1 Gunia, S.; Koch, S.; May, M. (Feb 2013). "Is CDX2 immunostaining useful for delineating anorectal from penile/vulvar squamous cancer in the setting of squamous cell carcinoma with clinically unknown primary site presenting with histologically confirmed inguinal lymph node metastasis?". J Clin Pathol 66 (2): 109-12. doi:10.1136/jclinpath-2012-201138. PMID 23105122.
  6. ↑ 6.0 6.1 Armstrong SA, Malley R, Wang H, Lenz HJ, Arguello D, El-Deiry WS, Xiu J, Gatalica Z, Hwang JJ, Philip PA, Shields AF, Marshall JL, Salem ME, Weinberg BA (October 2021). "Molecular characterization of squamous cell carcinoma of the anal canal". J Gastrointest Oncol 12 (5): 2423–2437. doi:10.21037/jgo-20-610. PMC 8576238. PMID 34790403. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8576238/.
  7. ↑ URL: https://www.cancer.org/cancer/types/anal-cancer/detection-diagnosis-staging/staging.html. Accessed on: June 26, 2023.
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