Contents
 

Malignant epidermal tumors



6  Skin tumors

6.3  Malignant epidermal tumors

6.3.1  Solar keratosis

Clinical signs:

  • predilection areas: face (forhead, temples, nose), ears, dorsa of the hands, back
  • variants: erythematous, hypertrophic, atrophic, papulous, lichenoid, pigmented; cornu cutaneum, actinic cheilitis a conjunctivitis
  • ulcerations and bleeding should raise suspicion of malignant transition

Pictures

Actinic keratosis, head; the size and hemorrhagic crust are suspicious of change into squamous carcinoma:
Actinic keratosis, CLINIC (653)

Multiple actinic keratoses:
Actinic keratosis, CLINIC (962)

Actinic keratoses:
Actinic keratosis, CLINIC (963)

Actinic keratosis:
Solar keratosis, CLINIC (3051)

Solar keratosis, CLINIC (3052)

Another examples of actinic keratosis:

Histology:

Intraepidermal carcinoma, characterised by dysplastic keratinocytes (especially in lower third of the epidermis). In some cases the acantholysis is present (lower part of the epidermis). Parakeratosis, sometimes hyperkeratosis.

Several forms: atrophic, acantholytic, hyperkeratotic.

Common features are dysplastic epithelium with mitotic activity and loss of dermal polarity. The dysplastic epithelium usually spreads down into the epithelium of the hair follicles.

Later infiltrative growth and transition into low grade squamous carcinoma.

Pictures

Solar keratosis (actinic keratosis), atrophic:
Solar (actinic) keratosis, atrophic, HE 20x (1962)

Another case of solar keratosis:
Solar keratosis, HE 40x (2568)

Another case of solar keratosis:
Solar keratosis, HE 60x (6408)

Another case of solar keratosis:
Actinic keratosis, HE 60x (10749)

Actinic keratosis, HE 60x (10750)

Solar keratosis:
Solar keratosis atrophic, HE 40x (12952)

Solar keratosis vs m. Bowen vs large cell acanthoma:
Actinic keratosis or m. Bowen or large cell acanthoma, HE 60x (12315)

Solar keratosis:
Solar keratosis, HE 40x (12787)

Solar keratosis, HE 40x (12788)

Solar keratosis:
Solar keratosis, HE 60x (13033)

Solar keratosis:
Solar keratosis, HE 60x (12074)

Solar keratosis:
Solar keratosis, HE 60x (14019)

Lichenoid solar keratosis:
Actinic keratosis, lichen planus-like, HE 60x (12012)

Solar keratosis, hyperkeratotic:
Solar keratosis hyperkeratotic, HE 20x (4389)
  [zoomify]

Solar keratosis, bowenoid:
Solar keratosis bowenoid, HE 60x (13684)

Cornu cutaneum based on solar keratosis:
Cornu cutaneum, HE 20x (5275)

Solar keratosis, lewandovsky-like:
Solar keratosis, HE 20x (4984)
  [zoomify]

Lichenoid solar keratosis:
Solar keratosis lichen planus like, HE 40x (12073)

6.3.1.1  Actinic cheilitis

Clinical signs:

  • location: lower lip
  • premalignant condition
  • scaly plaques, sometimes with ulcerations and/or erosions

Histology:

Cellular atypia, chronic inflammation with many plasma cells, ortho- and parakeratosis.

Pictures

Cheilitis solaris:
Cheilitis, actinic, HE 40x (4126)

6.3.2  Bowen's intraepidermal carcinoma

Clinical signs:

  • location: anywhere
  • flat, laterally spreading lesions
  • color: pink or red, sometimes with melanin pigmentation
  • scaling, sometimes crusts

Pictures

Morbus Bowen, detail:
Bowen's disease, CLINIC (977)

Morbus Bowen, calf:
Bowen's disease, CLINIC (978)

Morbus Bowen, temple:
Bowen's disease, CLINIC (979)

Multiple foci of Bowen's disease, changing into squamous cell carcinoma:
Spinalioma, CLINIC (983)

Another examples of Bowen's carcinoma:

Histology:

Dysplastic epithelium of high mitotic activity, usually within the full thickness of the epidermis, but the changes are sometimes less pronounced within the basal layer. Parakeratosis, hyperkeratosis, spread into the epithelium of hair follicles and sweat glands. After some time infiltrative growth.

Epidermis is often acanthotic and thickened. Malignant keratinocytes are sometimes pale (glycogen) and may form variable, usually irregular nests within the epidermis.

Case study:

Pigmented Bowen disease
MUDr. Jana Jedličková, PhD.

Introduction:

Morbus Bowen was described in 1912 by John T. Bowen and is regarded as a squamous cell carcinoma in situ. It is spreading superficially, progression to the invasive squamous cell carcinoma and metastases are rare. There are several variants of the disease:

  • Bowen disease of the skin associated with actinic damage, radiotherapy or exposition to arsenic or paraquat
  • Bowen disease of anogenital mucous membranes (erythroplasia of Queyrath, bowenoid papulosis)

Pigmented variant on extra-genital skin is uncommon; clinically it can be misdiagnosed as melanoma. A subungual variant with melanonychia was described, too.

History:

A 60-year-old man presented with many actinic keratoses of the sun-exposed areas. He was a phototype II, he suffered sunburn repeatedly in his active years (he had worked in Africa). At the clinical examination a red flat lesion with some brown pigment was found on his right arm. The patient had the lesion for many years; it was growing slowly, and was asymptomatic. Dermatoscopically there was no pigment net. The lesion was excised completely.

Clinical signs:

Red flat lesion 35×20 mm with irregular, sharply demarcated borders, some scaling, and a rim of brown pigment on the right arm. There was no lymphadenopathy. The patient had multiple actinic keratoses on the face, dorsal aspects of the hands, and upper back.

Histology:

Irregular nests of atypical cells with pigment and mitotic activity in the epidermis. The cells are AE1/AE3 positive, Melan A is positive only in solitary cells. In some parts the tumor bears resemblance to superficial basal cell carcinoma, however the nests are intraepidermal, formed by bowenoid cells.

The diagnosis: Clonal pigmented variant of Bowen intraepidermal carcinoma.

Pictures

Clonal Bowen carcinoma, forming intraepidermal nests of slightly pigmented keratinocytes, simulating melanoma:
Bowen's carcinoma, clonal, HE 40x (4116)

Bowen's carcinoma, clonal, AE13 40x (4115)

Bowen's carcinoma, clonal, Melan A 40x (4117)

6.3.2.2  Queyrat's disease

Histology:

Intraepidermal carcinoma, corresponding to the Bowen's disease, but localized on the penis.

6.3.2.3  Vulval intraepithelial neoplasia (VIN III.)

Histology:

Vulval intraepithelial neoplasia in high grade (VIN III.) coresponds to the Bowen's disease or Queyrat's disease, but is localized on the vulva.

Multinuclear atypia of the vulva is different entity, where multinuclear cells are present within the lower layers of the epithelium; other keratinocytes are without atypia.

6.3.2.4  Dysplasia/in situ carcinoma from basaloid cells

Introduction:

M. Queyrat variant. Usually in HIV positive patients.

Histology:

Basophilic cells replace the whole thickness of the epithelium. Dysplastic changes, mitotic activity.

6.3.3  Cornu cutaneum

Introduction:

The lesion is characterised by prominent hyperkeratosis. The origin varies (solar keratosis, vulgar verruca or some other hyperkeratotic process).

Clinical signs:

  • size: up to 1 cm, taller than high
  • there are literary descriptions of cutaneous horns of 10 cm in size or more

Histology:

Histology is variable, but massive hyperkeratosis is present, usually wiht parakeratosis.

Epithelium is often dysplastic.

6.3.3.1  Trichilemmal cornu cutaneum

Introduction:

Rare form of cornu cutaneum, characterized by trichilemmal keratinization within the tumor.

Pictures

Trichilemmal cornu cutaneum:
Trichilemmal cornu cutaneum, HE 60x (6183)

Trichilemmal cornu cutaneum:
Trichilemmal cornu cutaneum, HE 20x (5040)
  [zoomify]

6.3.4  Basalioma

Clinical signs:

  • location: often insolation areas, like the face, around the eyes and nose, shoulders, back
  • smooth, pink papule
  • elevated (pearly) border
  • variants: nodular, cystic, scletodermiform, pigmented, superficial

Pictures

Multiple basaliomas with pigment in hereditary syndrome of Gorlin:
Basalioma, CLINIC (663)

Basalioma, typical location at the base of the nose:
Basalioma, CLINIC (664)

Flat, inconspicuous carcinoma of the nose:
Basalioma, CLINIC (665)

Ulcerating basalioma with typical pearly border and scarring:
Basalioma, CLINIC (666)

Ulcerating basalioma, scalp:
Basalioma, CLINIC (667)

Ulcerating basalioma with hemorrhagic crust, temple:
Basalioma, CLINIC (668)

Ulcerating basalioma (ulcus rodens):
Basalioma, ulcus rodens, CLINIC (3400)

Basalioma:
Basalioma, ulcus rodens, CLINIC (3401)

Ulcerating basalioma, lower extremity:
Basalioma, CLINIC (966)

Ulcerating basalioma with pearly border:
Basalioma, CLINIC (967)

Ulcus rodens:
Basalioma, ulcus rodens, CLINIC (5545)

Ulcus rodens:
Basalioma, ulcus rodens, CLINIC (5546)

Smooth scar after cryotherapy of basalioma:
Basalioma, CLINIC (968)

Scarring and ulcerationg basalioma, nose:
Basalioma, CLINIC (969)

Nodular basalioma:
Basalioma, CLINIC (970)

Basalioma, nose (+ intradermal nevi):
Basalioma, CLINIC (971)

Basaliomas, temple:
Basalioma, CLINIC (972)

Basalioma, superficial:
Basalioma, CLINIC (973)

Basalioma terebrans:
Basalioma, CLINIC (974)

Basalioma:
Basalioma, CLINIC (975)

Multiple basaliomas with pigment, syndrome of Gorlin:
Basalioma, CLINIC (976)

Superficial basalioma:
Basalioma, superficial, CLINIC (2829)

Basalioma, superficial, CLINIC (2830)

Another examples of basalioma:

Histology:

The tumor consists of basophilic cells of high mitotic activity and roundish or oval shape. On the borders of tumorous nests there is usually palisading arrangement (exception: morphea-like basaliomas). The tumor is connected to the epidermis or adnexal epithelium. Artificial slits between the tumor and surrounding stroma are common.

Many variants: solid (nodular), superficial multicentric, cystic (cavities are caused by focal degeneration), adenoid, pigmented, invasive, morphea-like with sclerosis and infiltrative growth.

The peritumorus slits, basophilia and palisading are usually not present in invasive variants.

Basalioma fibroepithelial (fibroepithelioma of Pinkus) consists of multiple thin strands of tumorous epithelium which are connected to the epidermis. Stroma consists of fibrous tissue. Arteficial clefts between the epithelium and stroma are present. Peripheral palisading is focally present. Mitotic activity is usually low.

Pictures

Superficial basalioma:
Basalioma, superficial, HE 40x (2570)

Another case of superficial basalioma:
Basalioma, superficial, HE 40x (2571)

Large basalioma, infiltrating subcutis, bone and dura:
Basalioma, HE 20x (2521)

Basalioma, HE 40x (2522)

Basalioma, HE 40x (2544)

Large ulcerated basalioma, incomplete excision:
Basalioma, HE 5x (2609)

Basalioma:
Basalioma, HE 20x (3511)

Basalioma, HE 40x (3512)

Basalioma:
Basalioma, HE 60x (10130)

Basalioma, adamantoid:
Basalioma, adamantoid, HE 60x (12024)

Basalioma:
Basalioma, HE 40x (12794)

Basalioma:
Basalioma, HE 40x (12795)

Basalioma:
Basalioma, HE 40x (12796)

Basalioma:
Basalioma, HE 40x (12797)

Basalioma, PAS 40x (12798)

Basalioma, adenoid cystic:
Basalioma, adenoid cystic, HE 40x (12336)

Basalioma, adenoid cystic:
Basalioma, adenoid cystic, HE 40x (12650)

Basalioma, superficial:
Basalioma, superficial, HE 40x (12652)

Basalioma, superficial, HE 40x (12654)

Basalioma, superficial, HE 40x (12653)

Basalioma, superficial:
Basalioma, superficial, HE 60x (10131)

Basalioma, superficial, HE 60x (10132)

Basalioma with desmoplastic features with solar degeneration of the corium:
Basalioma, desmoplastic, HE 20x (12337)

Basalioma fibroepithelial (of Pinkus):
Fibroepithelioma (basalioma) of Pinkus, HE 20x (2029)

Fibroepithelioma (basalioma) of Pinkus, HE 40x (2030)

Another case of fibroepithelial bazalioma:
Fibroepithelioma (basalioma) of Pinkus, HE 20x (4943)
  [zoomify]

Another case of fibroepithelial bazalioma:
Fibroepithelioma (basalioma) of Pinkus, HE 20x (4426)
  [zoomify]

Another case of fibroepithelial bazalioma:
Fibroepithelioma (basalioma) of Pinkus, HE 20x (5233)

Another case of fibroepithelial bazalioma:
Fibroepithelioma (basalioma) of Pinkus, HE 20x (5393)

Another case of fibroepithelial bazalioma:
Fibroepithelioma (basalioma) of Pinkus, HE 60x (10277)

Another case:
Pinkus tumor, HE 40x (10935)

Basalioma growing from the follicular epithelium:
Bazalioma, infundibular, HE 40x (3686)

Cystic basalioma:
Basalioma, cystic, HE 20x (4064)

Basalioma, cystic, HE 40x (4065)

Cystic basalioma:
Basalioma, cystic, HE 20x (4427)
  [zoomify]

Another case:
Basalioma, HE 40x (4189)

Superficial basalioma combined with small intradermal melanocytic nevus:
Basalioma combined with melanocytic nevus, HE 40x (4292)

Tiny basalioma combined with seborrhoic keratosis:
Basalioma in combination with seborrhoic keratosis, HE 40x (5503)

Basalioma with focal squamoid differenciation:
Basalioma with focal squamoid metaplasia, HE 40x (4832)
  [zoomify]

Basalioma, sclerosing and infiltrating:
Basalioma, morpheiform, HE 40x (6117)

Sclerosing basalioma:
Basalioma, morpheiform, HE 60x (13816)

Spindle cell basalioma:
Spindle cell basalioma, HE 60x (13419)

Pale cell basalioma:
Clear cell basalioma, HE 60x (13427)

Pale cell basalioma:
Pale cell basalioma, HE 60x (13855)

Pale cell basalioma, AE13 20x (13853)

Pale cell basalioma, AE13 20x (13854)

Pleomorphic basalioma:
Pleomorphic basalioma, HE 60x (13905)

Basalioma, reexcision:
Basalioma, reexcision, HE 20x (5451)

Basalioma, sclerodermiform, radiodermatitis:
Sclerosing basalioma under rentgendermatitis, HE 40x (12941)

Basalioma, mimicking sudoriferous ducts (HE, CEA):
Bazalioma, simulating sweat ducts, HE 60x (12799)

Basalioma simulating sweat gland ducts, CEA 40x (12868)

Infiltrating basalioma of the skin near axilla, metastasizing to the axillary lymphnode:
Basalioma, skin near axilla, HE 40x (6194)

Basalioma metastasis to the lymphnode, HE 60x (6198)

Basalioma combined with intradermal melanocytic nevus:
Basalioma combined with melanocytic nevus, HE 60x (13702)

Basalioma combined with melanocytic nevus, HE 60x (13701)

Basalioma combined with intradermal melanocytic nevus:
Bazalioma combined with intradermal nevus, HE 60x (13765)

Basalioma combined with seborrhoic keratosis:
Seborrhoic keratosis combined with basalioma, HE 20x (13924)

6.3.5  Metatypic carcinoma (spinobazocellular)

Introduction:

Clinical appearance correspond to that of basalioma, but prognosis is closer to squamous carcinoma.

Histology:

The tumor consist of two structures: basalioma and squamous cell carcinoma. Both are malignant (as opposed to basalima with squamous metaplasia.

Pictures

Polypoid metatypic carcinoma:
Polypoid basosquamous carcinoma, HE 20x (5996)

Metatypic carcinoma:
Metatypic carcinoma, HE 40x (12800)

6.3.6  Squamous cell carcinoma

Clinical signs:

  • location: insolation areas (face, dorsa of the hands) and within areas of chronic irritation: chronic ulcers, scars, fistulas (tbc osteomyelitis) etc.
  • non-healing erosions with hemorrhagic crusts
  • non-healing ulcerations

Pictures

Destruction of the external ear in progressed squamous cell carcinoma:
Spinalioma, CLINIC (669)

Carcinoma spinocellulare:
Spinalioma, CLINIC (982)

Multiple foci of Bowen's disease, changing into squamous cell carcinoma:
Spinalioma, CLINIC (983)

Carcinoma spinocellulare:
Spinalioma, CLINIC (984)

Carcinoma spinocellulare exulcerans:
Spinalioma, CLINIC (985)

Squamous cell carcinoma of the lower lip:
Squamous cell carcinoma of the lower lip, CLINIC (5551)

Squamous cell carcinoma of the lower lip, CLINIC (5552)

Squamous cell carcinoma of the lower lip, CLINIC (5553)

Squamous cell carcinoma of the lower lip:
Squamous cell carcinoma, lower lip, CLINIC (3343)

Carcinoma spinocellulare in lupo:
Spinalioma, CLINIC (986)

Carcinoma spinocellulare, metastases:
Spinalioma, CLINIC (987)

Carcinoma spinocellulare, retroauricular:
Spinalioma, CLINIC (988)

Carcinoma spinocellulare, penis:
Squamous cell carcinoma, Macro (3714)

Squamous cell carcinoma, Macro (3715)

Squamous cell carcinoma, Macro (3716)

Squamous cell carcinoma, Macro (3717)

Squamous cell carcinoma, Macro (3718)

Squamous cell carcinoma, Macro (3719)

Squamous cell carcinoma, Macro (3720)

Squamous cell carcinoma, Macro (3721)

Squamous cell carcinoma of the lower lip, in addition solar elastosis with cysts and comedones in the skin (Syndrome of Favre Racouchot):
Squamous cell carcinoma of the lower lip, solar elastosis, cysts and comedones (Favre Racouchot), Macro (3722)

Squamous cell carcinoma of the lower lip, solar elastosis, cysts and comedones (Favre Racouchot), Macro (3723)

Squamous cell carcinoma of the lower lip, solar elastosis, cysts and comedones (Favre Racouchot), Macro (3724)

Squamous cell carcinoma of the lower lip, solar elastosis, cysts and comedones (Favre Racouchot), Macro (3725)

Squamous cell carcinoma of the lower lip, solar elastosis, cysts and comedones (Favre Racouchot), Macro (3726)

Squamous cell carcinoma of the lower lip, solar elastosis, cysts and comedones (Favre Racouchot), Macro (3727)

Squamous cell carcinoma of the lower lip, solar elastosis, cysts and comedones (Favre Racouchot), Macro (3728)

Another examples of squamous cell carcinoma:

Histology:

The tumor consists of malignant cells, corresponding to the keratinocytes of the spinous layer of the epidermis: eosinophilic cytoplasm, intercellular bridges, focal keratinisation (in differentiated tumors).

Tumorous cells are polymorphous, there is (often high) mitotic activity, focal necroses, infiltrative growth. Horn pearls are the sign of good differentiation. Sometimes acantholysis is present.

Pictures

Squamous cell carcinoma:
Squamous cell carcinoma, HE 10x (2442)

Squamous cell carcinoma, HE 40x (2443)

Squamous cell carcinoma, HE 40x (2444)

Another case:
Squamous cell carcinoma, HE 20x (2739)

Squamous cell carcinoma, HE 40x (2740)

Another case (next to osteomyelitic fistula; with pseudoepitheliomatous hyperplasia):
Squamous cell carcinoma, HE 20x (2507)

Squamous cell carcinoma, HE 40x (2508)

Another case of squamous cell carcinoma:
Squamous cell carcinoma, well differentiated, HE 20x (4036)

Squamous cell carcinoma, HE 40x (4037)

Another case of squamous cell carcinoma:
Squamous cell carcinoma of the skin, HE 40x (70284)

Squamous cell carcinoma:
Squamous cell carcinoma, HE 20x (4985)
  [zoomify]

Squamous cell carcinoma, ear:
Squamous cell carcinoma, HE 40x (5005)
  [zoomify]

Squamous cell carcinoma, ear:
Squamous cell carcinoma, ear, HE 20x (5471)

Squamous cell carcinoma, tongue:
Squamous cell carcinoma, HE 40x (70258)

Squamous cell carcinoma:
Squamous cell carcinoma, HE 40x (70285)

Another case:
Squamous cell carcinoma, HE 40x (6260)

Another case:
Squamous cell carcinoma, infiltrating, HE 20x (4699)
  [zoomify]

Well differentiated squamous cell carcinoma:
Squamous cell carcinoma, HE 20x (5291)

Infiltrating squamous cell carcinoma:
Squamous cell carcinoma, HE 60x (6338)

Squamous cell carcinoma:
Squamous cell carcinoma, HE 40x (10135)

Squamous cell carcinoma, HE 40x (10650)

Squamous cell carcinoma, HE 40x (10651)

Squamous cell carcinoma:
Squamous cell carcinoma, HE 40x (12981)

Squamous cell carcinoma, HE 40x (12982)

Squamous cell carcinoma:
Squamous cell carcinoma, HE 40x (12841)

Squamous cell carcinoma:
Myxoid carcinoma, HE 40x (12691)

Squamous cell carcinoma in an immunosuppressed patient:
Squamous cell carcinoma of an immunodeficient patient, HE 20x (4697)
  [zoomify]
Squamous cell carcinoma of an immunodeficient patient, HE 20x (4698)
  [zoomify]

Squamous cell carcinoma with prominent acantholysis:
Squamous cell carcinoma, acantholytic, HE 20x (4034)

Squamous cell carcinoma, acantholytic, HE 40x (4035)

Another example of acantholytic squamous cell carcinoma:
Squamous cell carcinoma, acantholytic, HE 40x (10924)

Squamous cell carcinoma, acantholytic, AE13 40x (10922)

Squamous cell carcinoma, acantholytic, Melan A 40x (10925)

Squamous cell carcinoma, acantholytic, CD34 40x (10923)

Another example of acantholytic squamous cell carcinoma:
Squamous cell carcinoma, acantholytic, HE 40x (6123)

Another example of acantholytic squamous cell carcinoma:
Squamous cell carcinoma, acantholytic, AE13 20x (13961)

Squamous cell carcinoma, acantholytic, HE 60x (13962)

Squamous cell carcinoma of the penis:
Squamous cell carcinoma, HE 40x (4067)

Squamous cell carcinoma of the ear:
Squamous cell carcinoma, ear, HE 20x (4997)
  [zoomify]

Infiltrating squamous cell carcinoma:
Squamous cell carcinoma, infiltrating, HE 40x (4302)
  [zoomify]

Squamous cell carcinoma with focal acantholysis:
Dediferentiated squamous cell carcinoma, HE 60x (10290)

Squamous cell carcinoma:
Squamous cell carcinoma, HE 40x (13255)

Undifferentiated squamous cell carcinoma:
Squamous cell carcinoma, low differentiated, HE 60x (12126)

Squamous cell carcinoma, lip:
Squamous cell carcinoma, lip, HE 40x (12538)

Squamous cell carcinoma, lip:
DG, HE 40x (75928)

Squamous cell carcinoma of the tongue, initial situation in diagnostic biopsy and condition after 4 months chemotherapy, when only small foci of granulomatous reaction after necrosis of tumorous cells is present:
Squamous cell carcinoma, tongue, HE 40x (5959)

Squamous cell carcinoma, tongue, after chemotherapy, HE 40x (5960)

Reexcision of a low differentiated squamous cell carcinoma in an immunosupressed patient:
Squamous cell carcinoma in immunosuppressed patient, HE 20x (4726)
  [zoomify]
Squamous cell carcinoma at immunosuppressed patient, HE 20x (4731)
  [zoomify]
Squamous cell carcinoma, low differentiated, AE13 20x (4761)

Low differentiated squamous cell carcinoma:
Dedifferentiated squamous cell carcinoma, HE 40x (10151)

Dediferentiated squamous cell carcinoma, HE 40x (10291)

Squamous cell carcinoma, external ear:
Squamous cell carcinoma, HE 20x (13788)

Low differentiated squamous cell carcinoma:
Squamous cell carcinoma, low differentiated, HE 20x (4771)

Squamous cell carcinoma, low differentiated, AE13 20x (4761)

Low differentiated squamous cell carcinoma:
Squamous cell carcinoma, low differentiated, HE 60x (6407)

Squamous cell carcinoma, spindle cells:
Fusicellular squamous cell carcinoma, HE 60x (13865)

Epidermal cyst with squamous cell carcinoma:
Squamous cell carcinoma within an infundibular cyst, HE 40x (4836)
  [zoomify]

Metastasis of squamous cell carcinoma of the dermis:
Squamous cell carcinoma, metastasis, HE 20x (6166)

6.3.6.1  Verrucous carcinoma

Clinical signs:

  • long lasting, non-healing verrucous lesion
  • location: soles, perigenital skin

Histology:

Irregular papillomatosis, acanthosis, well differentiated squamous epithelium, no significant cellular atypia. Mitotic activity is low. Keratin filled sinuses are formed. Focal parakeratosis, inflammation with the presence of neutrophils and eosinophils is present. The diagnosis is usually difficult, the tumor does not look malignant, repeated excisinos are often necessary to establish the diagnosis.

Pictures

Verrucous carcinoma:
Verrucous carcinoma, HE 40x (10069)

6.3.6.2  Giant condylomata of Buschke-Loewenstein

Clinical signs:

  • location: glans penis, preputium

Histology:

Large condyloma, epithelial proliferation and dysplasia.

6.3.6.3  Basaloid, cloacogenic carcinoma

Clinical signs:

  • location: perianal region, oropharynx

Etiology:

Most cases are associated with HPV infection.

Histology:

Tumor consists of small keratinocytes. High mitotic activity.

Pictures

Basaloid carcinoma, perianal region:
Basaloid carcinoma (cloacogenic), HE 60x (13870)

6.3.7  Lymphoepithelioma-like carcinoma of the skin

Clinical signs:

  • rare
  • location: face or scalp, rarely at other sites
  • papulonodular lesion
  • malignant, but metastases are rare

Histology:

Islands of roundish epithelial cells within the dense lymphocytic infiltrate. No keratinization. Histologically resembles nasopharyngeal carcinoma.

Pictures

Lymphoepithelioma-like carcinoma, perianal skin:
Lymphoepithelioma-like carcinoma, HE 40x (12911)

Lymphoepithelioma-like carcinoma:
Lymphoepithelioma-like carcinoma, HE 60x (13779)



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