Table of Contents
Definition / general | Epidemiology | Sites | Clinical features | Diagnosis | Laboratory | Radiology description | Prognostic factors | Case reports | Treatment | Clinical images | Gross description | Gross images | Microscopic (histologic) description | Microscopic (histologic) images | Positive stains | Negative stains | Differential diagnosisCite this page: Gupta N. Squamous cell carcinoma. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/ovarytumorscc.html. Accessed January 24th, 2021.
Definition / general
- Squamous cell carcinoma of ovary can be pure arising denovo or may represent extreme expression of squamous metaplasia in endometriosis, endometrioid carcinomas, transformation of ovarian teratomas and HPV related transformation
- Pure SCC and those arising from endometriosis are included in surface epithelial tumor by WHO Classification
- Often associated with dermoid cyst (50%) and endometriosis (20%)
- SCC arising in dermoid are included in germ cell tumor by WHO (Am J Surg Pathol 1996;20:823)
Epidemiology
- SCCD (associated with dermoid ): 21 - 75 (mean, 52) years old
- SCCE (associated with endometriosis ): 29 - 70 (mean, 49) years old
- SCCP (Pure SCC): 27 - 73 (mean, 56) years old (Am J Surg Pathol 1996;20:823)
Sites
- Genital and extragenital SCC
Clinical features
- Lower abdominal mass
Diagnosis
- Final diagnosis is by histology
Laboratory
- CA 125: Normal to mildly elevated (Int J Gynaecol Obstet 2010;108:16)
Radiology description
- USG: Heterogeneous solid and cystic mass 10 - 15 cm in maximum diameter (Int J Gynaecol Obstet 2010;108:16)
Prognostic factors
- Poor prognosis
- The stage of the tumor and its grade correlated best with overall survival (Am J Surg Pathol 1996;20:823)
Case reports
- 40 year old woman with bilateral primary ovarian squamous cell carcinoma (Am J Surg Pathol 1996;20:767)
- 45 year old woman with squamous cell carcinoma of the ovary (Arch Pathol Lab Med 1987;111:864)
- 62 year old woman with squamous cell carcinoma in situ arising in mature cystic teratoma of the ovary (J Ovarian Res 2011;4:5)
- Pure primary squamous cell carcinoma of the ovary (Int J Gynecol Pathol 2010;29:328)
Treatment
- Total abdominal hysterectomy, bilateral salpingo-oophorectomy and omentectomy, with additional steps as needed to ensure surgical debulking of all grossly visible disease
- Role of adjuvant chemo and radiotherapy debatable
- Few case report noted a response to early pa-clitaxel in combination with a platinum agent (Gynecol Oncol 2000;79:515)
Gross description
- 6 - 35 cm
- Often forming mural nodules with intracavitary protrusion
- Focal necrosis and hemorrhage
Microscopic (histologic) description
- Can be well to poorly differentiated
- Well differentiated form, SCC will show squamous maturation, keratin formation and intracellular bridging
- Poorly differentiated form, few normal squamous features may be identifiable
Microscopic (histologic) images
Positive stains
- MA903, p63 and CK5 / 6
Negative stains
- CA 125
Differential diagnosis
- Metastatic SCC: primary elsewhere especially cervix
- Squamous metaplasia in endometrioid carcinoma: absence of malignant features