Squamous cell carcinomas in children and young adults: a new wave of a very rare tumor?
BACKGROUND
Squamous cell carcinomas (SCCs) seem to have become more common recently. This study aims to check whether the increase is real and to review possible etiologic factors and problems in diagnosis.


METHODS
Patients with SCC were identified from anatomical pathology files over 30 years. The number and primary sites seen in the first 15 years were compared with those in the second. Histories were reviewed for predisposing factors. Mucosal tumors were tested for human papillomavirus (HPV) and Epstein-Barr virus by polymerase chain reaction.


RESULTS
One cutaneous SCC and 2 nasopharyngeal carcinomas (NPCs) were seen in the first period, and 2 cutaneous SCCs and 3 nasopharyngeal carcinomas in the second. Another 9 patients with mucosal SCCs were seen in the second period, many with history of cancer treatment or immunosuppression. Two laryngeal SCCs were HPV16-positive. Histologic diagnosis was difficult in 3 patients.


CONCLUSIONS
Squamous cell carcinomas have become more common in the last 15 years. Causes include improved survival of cancer patients, therapeutic irradiation, immunosuppression, and possibly, increased prevalence of HPV in the community. Awareness of this increase in children, early biopsy in susceptible patients, repeat wider biopsy, and consultation with adult pathologists may reduce the diagnostic delay.
Chow
Chung Wo
CW
Department of Anatomical Pathology, Royal Children's Hospital, Melbourne 3052, Australia. cw.chow@rch.org.au
Tabrizi
Sepher N
SN
Tiedemann
Karin
K
Waters
Keith Daniel
KD
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D001315:Australia / Q000453:epidemiology; D001707:Biopsy, Needle; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology* / Q000473:pathology* / Q000628:therapy; D002648:Child; D003131:Combined Modality Therapy; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D015994:Incidence; D008297:Male; D009061:Mouth Mucosa / Q000473:pathology; D009297:Nasal Mucosa / Q000473:pathology; D009303:Nasopharyngeal Neoplasms / Q000453:epidemiology* / Q000473:pathology* / Q000628:therapy; D009367:Neoplasm Staging; D035583:Rare Diseases; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D017678:Sex Distribution; D012878:Skin Neoplasms / Q000453:epidemiology* / Q000473:pathology* / Q000628:therapy; D016019:Survival Analysis