SCC - Histology

What is SCC?

Squamous cell carcinoma (SCC) is a type of cancer that originates in the squamous cells, which are flat, thin cells found on the surface of the skin and various mucous membranes throughout the body. SCC is one of the most common forms of skin cancer, but it can also occur in other areas such as the lungs, esophagus, and cervix.

Histological Features of SCC

Histologically, SCC is characterized by the proliferation of atypical squamous cells. These cells may exhibit varying degrees of differentiation, from well-differentiated tumors with keratin pearl formation to poorly differentiated tumors with significant cellular atypia and mitotic activity. Key features include:

Keratinization: Presence of keratin pearls or keratinized cells.
Intercellular Bridges: Desmosomal connections between squamous cells.
Acantholysis: Loss of cell-to-cell adhesion, leading to the formation of intraepidermal clefts.
Nuclear Atypia: Enlarged, hyperchromatic nuclei with irregular contours.
Increased Mitotic Activity: Indicative of rapid cell division.

Pathogenesis of SCC

The pathogenesis of SCC involves a combination of genetic, environmental, and lifestyle factors. Chronic exposure to ultraviolet (UV) radiation is a major risk factor, particularly for cutaneous SCC. Other contributing factors include chemical carcinogens, chronic inflammation, and human papillomavirus (HPV) infection, especially in mucosal SCCs.

Diagnosis of SCC

The diagnosis of SCC typically involves a combination of clinical evaluation and histopathological examination. A biopsy is performed to obtain tissue samples, which are then stained and examined under a microscope. Immunohistochemical staining may be employed to differentiate SCC from other types of carcinomas and to determine the degree of differentiation.

Treatment Options

Treatment for SCC varies depending on the location, size, and stage of the tumor. Common treatment modalities include:

Surgical Excision: Complete removal of the tumor with clear margins.
Mohs Micrographic Surgery: A tissue-sparing technique used primarily for skin SCC.
Radiation Therapy: Often used for tumors that are not amenable to surgery.
Chemotherapy: Systemic treatment for advanced or metastatic SCC.
Targeted Therapy: Involves drugs that specifically target molecular pathways involved in tumor growth.

Prognosis and Follow-Up

The prognosis for SCC depends on various factors, including the tumor's size, depth of invasion, and degree of differentiation. Early detection and treatment are crucial for a favorable outcome. Regular follow-up is essential to monitor for recurrence or metastasis, especially in high-risk patients.

Prevention Strategies

Preventive measures can significantly reduce the risk of developing SCC. These include:

Sun Protection: Using sunscreen, wearing protective clothing, and avoiding peak UV radiation hours.
Avoiding Carcinogens: Limiting exposure to known chemical carcinogens.
HPV Vaccination: Reducing the risk of HPV-associated SCCs.
Regular Skin Checks: Early detection through self-examination and professional skin assessments.