Definition/General

Introduction:
-Cutaneous squamous cell carcinoma (SCC) is a malignant tumor of epidermal keratinocytes
-It is the second most common skin cancer after basal cell carcinoma
-SCC shows potential for metastasis
-Most cases are related to chronic UV exposure.
Origin:
-Arises from keratinocytes in epidermis or adnexal structures
-Develops from actinic keratosis (precursor lesion)
-De novo development possible
-Squamous differentiation with keratinization
-Invasive growth pattern.
Classification:
-WHO classification of keratinocytic tumors
-Conventional SCC
-Keratoacanthoma
-Adenosquamous carcinoma
-Spindle cell SCC
-Basosquamous carcinoma
-Verrucous carcinoma.
Epidemiology:
-Peak incidence 60-80 years
-Male predominance
-Higher in fair-skinned individuals
-Sun-exposed areas most common
-Increasing incidence with aging population and UV exposure.

Clinical Features

Presentation:
-Scaly, crusted nodule
-Ulcerated lesion
-Indurated plaque
-Bleeding or friable surface
-Non-healing wound
-Rapidly growing lesion
-Pain or tenderness.
Risk Factors:
-Chronic UV exposure
-Fair skin (Fitzpatrick I-II)
-Immunosuppression
-HPV infection
-Chronic wounds
-Burn scars
-Chemical exposure
-Radiation therapy.

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Gross Description

Microscopic Description

Immunohistochemistry

Molecular/Genetic

Differential Diagnosis

Sample Pathology Report

Template Format

Sample Pathology Report

Complete Report: This is an example of how the final pathology report should be structured for this condition.

Specimen Information

[excision/biopsy], [location], measuring [size] cm

Tumor Size

Tumor measures [X] x [Y] cm, thickness [Z] mm

Histologic Type

Squamous cell carcinoma, [conventional/variant] type

Differentiation

[Well/Moderately/Poorly] differentiated

Depth of Invasion

Invades to [papillary/mid/deep] dermis, depth [X] mm

Surgical Margins

Margins: [negative/positive], closest margin [distance] mm

Perineural Invasion

Perineural invasion: [present/absent]

Lymphovascular Invasion

Lymphovascular invasion: [present/absent]

Precursor Lesion

Associated actinic keratosis: [present/absent]

Risk Assessment

Risk of metastasis: [low/high] based on [factors]

Immunohistochemistry

p63: [positive], CK5/6: [positive] (if performed)

Final Diagnosis

Final diagnosis: Cutaneous squamous cell carcinoma, [differentiation], [margins status]