Prostate gland & seminal vesicles

Squamous carcinomas

Squamous cell carcinoma


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

Last author update: 18 February 2019
Last staff update: 4 October 2023

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


Kenneth A. Iczkowski, M.D.
Komal Arora, M.D.
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Cite this page: Iczkowski KA. Squamous cell carcinoma. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/prostatesquamous.html. Accessed March 28th, 2024.
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
Adenosquamous carcinoma
Laboratory
Radiology images

Contributed by Kenneth A. Iczkowski, M.D.
T2 weighted MRI

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

Needle biopsy

Keratinization with necrosis

Keratinization with necrosis

Multinucleation

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 style 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 style answer #1
D. Presence of squamous cell carcinoma elsewhere

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Reference: Squamous cell carcinoma
Board review style 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 style answer #2
C. More often occurs following radiotherapy or antiandrogen therapy than in the absence of those prior therapies.

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Reference: Squamous cell carcinoma
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