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Squamous cell carcinoma

• This is the 2nd most common carcinoma of skin(first, being basal cell carcinoma). • They may arise in any part of skin and mucous membrane lined by squamous epithelium but more likely occurs on sun exposed parts. • It is commoner in older males.

• Most common sites are face, pinna of ears back of hands,and mucocutneous junctions like lips and anal canal. • It may occur on surface covered by glandular epithelium after metaplastic transmission like in gallbladder bronchus and uterine cervix. • Predisposing factors • Solar keratosis,chronic ulcers,draining sinus osteomyelitis, old burns scars, ionising radiation all can lead to Squamous cell Ca. In oral cavity chewing betelnuts and tobacco predispose to cancer.

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Predisposing conditions
• Solar keratosis,chronic ulcers,draining sinus osteomyelitis, old burns scars, ionising radiation all can lead to Squamous cell Ca. In oral cavity chewing betelnuts and tobacco predispose to cancer.

Gross appearance
It is in the form of : 2. ulcerated or nodular growth. 3. Fungating or polypoid growth without ulceration. It starts as small papular mass, the surface breaks down and characteristic ulcer is formed with everted and raised edges.The cut section shows greyish white endophytic and exophytic tumor.

Microscopic appearance
• Squamous cell carcinoma can be confined to epidermis called as Carcinoma in situ (i.e. within BM) or may be invasive carcinoma. • Invasive carcinomas are characterised by irregular downward proliferation of malignant cells into the dermis through the basement membrane.The malignant epidermal cells show atypical features such as variation in cell size and shape hyperchromatosis ,atypical mitotic figures,keratinisation etc .

• Better differentiated types have whorled arrangement of malignant cells forming pearls which contain laminated keratin in the centre.This is typically called as Epithelial pearl. • All variants show inflammatory reaction in form of lymphocytes .

Grading of tumor depends on the percentage of anaplastic cells .Accordingly we have, Well differentiated Moderately diff Undifferentiated keratinising Nonkeratinising and Spindle cell type of squamous cell carcinomas.

Malignant cell secreting keratin