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Squamous carcinoma in scars: clinicopathological correlations.
V Visuthikosol1, V Boonpucknavig, P Nitiyanant
1Department of Surgery, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Annals of Plastic Surgery
|January 1, 1986
Summary
Prognosis for scar squamous cell carcinoma may depend on tumor differentiation and host immune response. Moderate lymphocyte infiltration correlates with better outcomes, unlike minimal infiltration seen in aggressive cases.
Area of Science:
- Dermatology
- Oncology
- Pathology
Background:
- Squamous cell carcinoma (SCC) can arise in scars, but its prognosis is not well-defined.
- Previous understanding suggested a universally poor prognosis for scar-associated SCC.
Purpose of the Study:
- To investigate factors influencing prognosis in SCC arising in scars.
- To correlate tumor characteristics and host immune response with patient outcomes.
Main Methods:
- Analysis of twelve cases of cutaneous squamous cell carcinoma arising in scars.
- Evaluation of tumor differentiation, cellular atypia (pleomorphism, spindle cells), and small lymphocyte infiltration.
- Assessment of adjacent collagen tissue and tumor stroma.
Main Results:
- All tumors were predominantly well-differentiated SCC.
- Nine patients achieved no metastasis or recurrence after surgery.
- Three patients developed widespread metastases and died within two years.
- Aggressive tumors (metastasis/recurrence) showed pleomorphic/spindle cells and minimal lymphocyte infiltration.
- Favorable outcome tumors had moderate lymphocyte infiltration, with rare areas of pleomorphism.
Conclusions:
- Prognosis in scar-associated SCC may be linked to tumor differentiation and host immune response (lymphocyte infiltration).
- The degree of small lymphocyte infiltration is a potential indicator of patient outcome.
- Findings challenge the historically poor prognosis associated with scar carcinoma.