[Clinico-histologic characteristics of spinocellular carcinoma of the skin].

INTRODUCTION

Authors present clinical-histological characteristics of squamous cell carcinomas of the skin in patients treated at the Clinic of Infectious and Dermato-Venereology Diseases in Novi Sad in the period from 1989 to 1995.

MATERIAL AND METHODS

The examined group comprised 26 cases (2.32%) with histologically verified squamous cell carcinomas of the skin out of 1119 nonmelanomatous epithelial skin tumors, clinically examined by dermatologists and treated by x-ray surface therapy. All patients with SCC were clinically examined by dermatologists at the Clinic of Dermatology and Venereology in Novi Sad, while histological examinations were performed by pathologists of the department of Pathology and Histology of the Faculty of Medicine in Novi Sad. Tumor biopsy specimens were obtained by shave biopsy, saucer biopsy and punch biopsy. All the biopsy specimens wee histologically examined and verified with standard methods with haematoxyllineosin-staining.

RESULTS

In the group of examined patients most were with SCC--that is exophytic tumor of the skin in 16 cases (61.54%). Histological examination revealed: squamous cell carcinoma of the skin in 9 cases (56.25%), keratotic squamous cell carcinoma in 5 cases (31.25%) and invasive squamous cell carcinoma in 2 cases (12.50%). In the examined group there were also 9 cases of SCC (36.41%) with clinical forms of endophytic tumor of the skin. By histological examination the following tumors were diagnosed: Morbus Bowen in 3 cases (incipient squamous cell carcinoma of the skin) (33.33%); squamous cell carcinoma of the skin in 5 cases (55.56%) and keratotic squa- mous cell carcinoma in 1 case (11.11%). In one case SCC with clinical features like keratoacanthoma was found (3.85%), while by histological examination keratotic squamous cell carcinoma of the skin was diagnosed.

DISCUSSION

In regard to the biopsy technique, SCC of the skin was diagnosed mostly as spinocellular carcinoma of the skin in 14 cases (53.85%) without a more precise description of the degree of tumor cells degeneration as well as tumor edge characteristics and type of histological type of tumor. Keratotic squamous cell carcinoma was found in 7 cases (26.92%); it is a tumor of mature structure (1-2 Broders' grade of clinical stage of tumors), but also without a detailed description of the tumor edge and type of histological type of tumor. Invasive squamous cell carcinoma was found in 2 cases (7.96%) and it reveals a SCC of the skin with deep infiltration into the dermis and hypodermis, sometimes involving the neighboring tissue (cartilage tissue, bone, muscle tissue and so on). This histological form of SCC had 3-4 Broders' grade of clinical stage of tumors.

CONCLUSION

Authors of the paper conclude that histological examinations of SCC of the skin are necessary meaning detailed analysis: degree of differentiation of tumor cells by Broders' examination, examination of tumor edges and histological types of tumor. The incisional biopsy of tumor lesions had only been used to confirm clinical diagnosis in order to perform x-ray therapy, but it could not meet necessary criteria the excisional biopsy could in regard to evaluate tumor edges and histological type of the tumor.