Squamous cell carcinoma

• This is the 2nd most common carcinoma of

skin(first, being basal cell carcinoma).
• They may arise in any part of skin and
mucous membrane lined by squamous
epithelium but more likely occurs on sun
exposed parts.
• It is commoner in older males.
 Sites
• Most common sites are face, pinna of ears
back of hands,and mucocutneous junctions like
lips and anal canal.
• It may occur on surface covered by glandular
epithelium after metaplastic transmission like in
gallbladder bronchus and uterine cervix.
• Predisposing factors
• Solar keratosis,chronic ulcers,draining sinus
osteomyelitis, old burns scars, ionising
radiation all can lead to Squamous cell Ca. In
oral cavity chewing betelnuts and tobacco
predispose to cancer.
 Predisposing conditions
• Solar keratosis,chronic ulcers,draining
sinus osteomyelitis, old burns scars,
ionising radiation all can lead to
Squamous cell Ca. In oral cavity chewing
betelnuts and tobacco predispose to
cancer.
 Gross appearance
It is in the form of :
2. ulcerated or nodular growth.
3. Fungating or polypoid growth without
ulceration.
It starts as small papular mass, the surface
breaks down and characteristic ulcer is
formed with everted and raised edges.The
cut section shows greyish white endophytic
and exophytic tumor.
 Microscopic appearance
• Squamous cell carcinoma can be confined
to epidermis called as Carcinoma in situ (i.e.
within BM) or may be invasive carcinoma.
• Invasive carcinomas are characterised by
irregular downward proliferation of malignant
cells into the dermis through the basement
membrane.The malignant epidermal cells
show atypical features such as variation in
cell size and shape hyperchromatosis
,atypical mitotic figures,keratinisation etc .
• Better differentiated types have whorled
arrangement of malignant cells forming
pearls which contain laminated keratin in
the centre.This is typically called as
Epithelial pearl.
• All variants show inflammatory reaction in
form of lymphocytes .
Grading of tumor depends on the
percentage of anaplastic cells .Accordingly
we have, Well differentiated
Moderately diff
Undifferentiated keratinising
Nonkeratinising and
Spindle cell type of squamous cell
carcinomas.
Malignant cell secreting keratin