American Urological Association - Carcinoma With Squamous Differentiation
Carcinoma With Squamous Differentiation
- Primary carcinoma of prostate with squamous cell features and includes pure squamous cell carcinoma (SCC) and adenosquamous carcinoma (ASC) or adenocarcinoma mixed with squamous cell carcinoma
- Very rare, only ~55 cases SCC and ~30 cases ASC reported.
- Diagnosis requires exclusion of secondary prostate SCC from other organs.
- Both SCC and ASC can arise de novo or preceded by prior prostate adenocarcinoma with or without prior radiation or hormonal treatment.
- Serum PSA or PSAP typically normal, even with advanced disease.
- Generally poor response to surgical, hormonal, chemotherapeutic, or radiation therapies.
- Pure SCC is similar to SCC of other anatomic sites (e.g. keratin formation, intercellular desmosomes, etc.) (image A) & (image B).
- Well to poorly differentiated (Broder's grading).
- Glandular component of ASC similar to acinar adenocarcinoma.
- By immunohistochemistry:
- SCC is PSA- and PSAP- and HMWK+.
- Glandular component of ASC is PSA+ and PAP+ and HMWK-.
- Do not confuse this with squamous metaplasia adjacent to an infarct (much more common diagnosis).
- Behave more aggressively than prostate adenocarcinoma.