Cutaneous squamous cell carcinoma - Anogenital in
Almost one-third of patients with vulvar tumors present with locally advanced disease, usually resulting from late presentation due to older age, lack of access to medical care, or perceived embarrassment regarding tumor location. Late-stage tumors are more difficult to treat and may require radical surgical intervention.
The clinical presentation is variable. SCC often presents as a hyperkeratotic papule or nodule that may ulcerate, but it may also be smooth, plaque-like, exophytic, or papillomatous. Lesions are often red to skin colored. Secondary changes such as scale, crust, erosion, and ulceration may be present. The progression of lesions over time varies. Some enlarge slowly, while others progress rapidly to grow, infiltrate deeper tissue, and metastasize. Pain and tenderness can be present. Anal carcinomas may also present with rectal bleeding and a sensation of an object in the rectum.
The pathogenesis of SCC is multifactorial. It may evolve from intraepithelial neoplasia (including vulvar intraepithelial neoplasia or anal intraepithelial neoplasia) or arise de novo. TP53 gene mutations have been implicated. Any repetitive trauma or insult increases the risk of SCC. Additional risk factors for anogenital SCC include smoking, sexually transmitted infections, HIV infection, human papillomavirus (HPV) infection, poor genital hygiene, anogenital injury, lichen sclerosus, and erosive lichen planus.
Women who engage in receptive anal intercourse and women with immunocompromised states such as HIV should undergo regular anal Papanicolaou (Pap) screening tests.
Related topics: bowenoid papulosis, squamous cell carcinoma in situ
C44.92 – Squamous cell carcinoma of skin, unspecified
402815007 – Squamous cell carcinoma
Differential Diagnosis & Pitfalls
- Bowen disease
- Basal cell carcinoma
- Verruca vulgaris
- Condyloma acuminatum
- Eccrine poroma
- Lobular capillary hemangioma (pyogenic granuloma)
- Amelanotic melanoma
- Mycobacterium marinum infection
- Nummular dermatitis
- Irritated seborrheic keratosis
- Chronic draining or ulcerative lesions
- Lichen planus
- Lichen sclerosus
- Granuloma inguinale
- Lymphogranuloma venereum
- Prurigo nodularis
- Bowenoid papulosis
- Adnexal carcinomas
- Dermatofibrosarcoma protuberans
- Extramammary Paget disease
- Epithelioid sarcoma
- Lichen simplex chronicus
- Basosquamous carcinoma
Drug Reaction Data