Squamous cell carcinoma with osteoclast-like giant cells: a morphologically heterologous group including carcinosarcoma and squamous cell carcinoma with stromal changes.
Cutaneous squamous cell carcinoma (SCC) with osteoclast-like giant cells (hereafter, osteoclastic cells) is very rare; eight cases have been reported since 2006. Whether the osteoclastic cells represents a reactive or neoplastic change remains a matter of debate. Osteoclastic cells are often observed in the sarcomatous component of cutaneous carcinosarcoma. SCC with osteoclastic cells is a heterogeneous condition that includes SCC with stromal changes containing osteoclastic cells (also known as osteoclast-like giant cell reaction) and carcinosarcoma. In some cases, SCC with an associated osteoclast-like giant cell reaction has been differentiated from carcinosarcoma based on the degree of cytologic atypia in non-epithelial components. We summarized the clinical and histopathologic characteristics of 11 patients of SCC with osteoclastic cells, including our two cases of SCC with an osteoclast-like giant cell reaction and one case of carcinosarcoma. The affected patients were old and more likely to be male (64%). Seven cases (64%) were in the head and neck. Moreover, multiple features of high risk SCC were observed, such as a tumor size greater than 2 cm (56%), moderate or poor differentiation (100%), recurrence (33%) and nodal metastasis (17%) after excision and immunosuppression (27%). Interestingly, half of the previously reported cases of SCC with osteoclastic giant cell reaction had histopathologic findings that were overlapping with those of carcinosarcoma.
Department of Dermatology, Dermatopathology Section, Boston University School of Medicine, Boston, MA, USA.
Hye Jin
HJ
Chung
Department of Dermatology, Dermatopathology Section, Boston University School of Medicine, Boston, MA, USA.
Deon
D
Wolpowitz
Department of Dermatology, University of Rochester Medical Center, Rochester, NY, USA.
Glynis
G
Scott
Department of Dermatology, University of Rochester Medical Center, Rochester, NY, USA.
Elaine
E
Gilmore
Department of Dermatology, University of Rochester Medical Center, Rochester, NY, USA.
Jag
J
Bhawan
D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000378:metabolism / Q000473:pathology; D002296:Carcinosarcoma / Q000378:metabolism / Q000473:pathology; D005260:Female; D015726:Giant Cells / Q000378:metabolism / Q000473:pathology; D006258:Head and Neck Neoplasms / Q000378:metabolism / Q000473:pathology; D006801:Humans; D008297:Male; D010010:Osteoclasts / Q000378:metabolism / Q000473:pathology; D012878:Skin Neoplasms / Q000378:metabolism / Q000473:pathology
atypical fibroxanthoma; carcinosarcoma; osteoclast; osteoclast-like giant cell reaction; squamous cell carcinoma