Prostate
Other carcinomas
Squamous cell carcinoma

Editorial Board Member: Maria Tretiakova, M.D., Ph.D.
Editor-in-Chief: Debra Zynger, M.D.
Kenneth A. Iczkowski, M.D.

Topic Completed: 18 February 2019

Revised: 5 March 2019

Copyright: 2003-2019, PathologyOutlines.com, Inc.

PubMed Search: Squamous cell carcinoma [title] prostate "loattrfree full text"[sb]


Kenneth A. Iczkowski, M.D.
Page views in 2018: 481
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Cite this page: Iczkowski KA. Squamous cell carcinoma. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/prostatesquamous.html. Accessed July 22nd, 2019.
Definition / general
Essential features
  • Criteria for diagnosis of pure primary squamous cell carcinoma of the prostate:
    • Unequivocal features of malignancy
    • Definitive squamous differentiation
    • Lack of admixed conventional carcinoma component (would be adenosquamous) (Rare Tumors 2010;2:e47)
    • No squamous cell carcinoma elsewhere (Mod Pathol 2004;17:316)
Epidemiology
Pathophysiology
  • Possible origin (J Clin Pathol 1988;41:1288):
    • Purely prostatic with transformation of adenocarcinoma
    • Collision tumor
    • Derived from pluripotent stem cells
    • Clonal evolution of adenocarcinoma under pressure from therapy
    • Squamous differentiation of a prostatic urethral primary tumor
Clinical features
Laboratory
Radiology images

Contributed by Kenneth A. Iczkowski, M.D.

T2 weighted MRI

Case reports
Treatment
Gross description
Microscopic (histologic) description
  • Pure tumors exhibit infiltrating nests, strands and sheets of polygonal cells with nuclear atypia
  • Squamous differentiation is manifested as individual cell keratinization, intercellular bridges or keratin pearl formation
Microscopic (histologic) images

Contributed by Kenneth A. Iczkowski, M.D.

Needle biopsy

Keratinization with necrosis

Multinucleation



Images hosted on other servers:

Squamous cell carcinoma

Positive stains
Negative stains
Differential diagnosis
  • Urothelial carcinoma
    • Lacks keratin or intercellular tonofilament bridges
    • Negative for PSA; positive for uroplakin II and GATA3
    • Will not have adenosquamous areas
  • Urothelial carcinoma with squamous differentiation
    • May be difficult to impossible to differentiate
    • Will not have adenosquamous areas
  • Squamous carcinoma of other origins such as penis, bladder or anorectal
    • Requires clinical and radiologic correlation
    • Will not have adenosquamous areas
  • Squamous metaplasia
    • Can be seen around infarcts within the prostate
    • Lacks overt pleomorphism and atypical mitotic figures; does not form a mass
Board review question #1
A finding that may rule out a primary pure squamous cell carcinoma of the prostate is

  1. Negative for low molecular weight cytokeratin
  2. Negative for prostate specific antigen
  3. Presence of keratin
  4. Presence of squamous cell carcinoma elsewhere
Board review answer #1
D. Presence of squamous cell carcinoma elsewhere

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Board review question #2
The following is true about squamous cell carcinoma of the prostate

  1. Does not originate adjacent to coexisting squamous metaplasia
  2. More likely to occur as a focus separate from adenocarcinoma, rather than intermixed and merging with adenocarcinoma
  3. More often occurs following radiotherapy or antiandrogen therapy than in the absence of those prior therapies
  4. Serum PSA elevation is useful for diagnosis of the pure form of squamous cell carcinoma
Board review answer #2
C. More often occurs following radiotherapy or antiandrogen therapy than in the absence of those prior therapies.

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