Nomenclature for Very Superficial Squamous Cell Carcinoma of the Skin and of the Cervix: A Critique in Historical Perspective

Abstract

Squamous-cell carcinoma is the most common of all cancers and it develops in diverse organs of the body, among those being the skin, lung, gastrointestinal tract, and genitourinary tract, the latter including the cervix. Unfortunately, no unanimity exists for naming very superficial squamous-cell carcinoma; it has not been designated in consistent fashion in a single organ, let alone in all of them, thereby resulting in confusion, not only in regard to terminology per se, but concerning matters conceptual, not the least of those being what appellation to apply to that condition when it is encountered histopathologically. This vexing situation is illustrated graphically in the skin by diagnoses for very superficial squamous-cell carcinoma as disparate as solar keratosis (actinic keratosis, senile keratosis), arsenical keratosis, radiation keratosis, Bowen disease, bowenoid papulosis, squamous-cell carcinoma in situ, as well as variations on the theme of "keratinocytic intraepidermal neoplasia" and "dysplasia," and in the cervix by squamous-cell carcinoma in situ, leukoplakia, cervical intraepithelial neoplasia I-III, as well as variations on the theme of "squamous dysplasia ()." What follows now is a recounting of the history of the subject under consideration here, a critique of dizzying, opaque terms and phrases given to that subject, and a proposal for rectifying what currently is a thoroughly untenable situation because the language, and the ideas expressed by it, are impenetrable to physicians and, thereby, are decidedly disadvantageous to patients. There is a need urgently for a single term for very superficial squamous-cell carcinoma in every organ of the body in which it develops, to wit, one that conveys diagnosis in such logical, lucid, comprehensible fashion that it is understandable, readily and immediately, to clinicians. In that way, physicians charged with management of patients can plan therapy rationally.

Viral-Associated Nonmelanoma Skin Cancers: A Review

“…63,87,88 Full-thickness epidermal dysplasia with crowding of keratinocytes and loss of architecture is demonstrated in BP lesions (Fig. 3).…”

“…[62][63][64][65] Evidence for HPV as an etiologic agent first appeared in 1978 by studies by Wade et al 66 Various high-risk HPV types have been linked to BP, particularly HPV types 16 and 18. HPV types 31, 32, 34, 39, 42, 48, and 51-54 have also been found in BP lesions at a greater frequency than in normal controls.…”

Clearance of a Thick Invasive Squamous Cell Carcinoma After Multiple Treatments with Topical Photodynamic Therapy

“…4 Both AK and BD are intraepithelial SCCs that may give rise to invasive SCC. 5 Topical PDT trials have been carried out in treating cutaneous SCCs; however, the recurrence rates range from 0 to 69%, suggesting that tumor-response depth is a key limiting factor for invasive SCCs, although further studies are required. [6][7][8] A tumor-response depth of < 2-3 mm is presently recommended for nonmelanoma skin cancers.…”

Cytokeratin 17: An Adjunct Immunohistochemical Marker of Invasion in Squamous Neoplastic Skin Lesions

“…Although actinic keratosis is included in precancerous lesions, some authors describe actinic keratosis as "keratinocytic intraepidermal neoplasia" or "solar keratotic intraepidermal SCC" (19,20). Bowenoid-type actinic keratoses are difficult, sometimes impossible, to distinguish microscopically from Bowen's disease because of their full-layer epidermis involvement (19).…”

“…Bowenoid-type actinic keratoses are difficult, sometimes impossible, to distinguish microscopically from Bowen's disease because of their full-layer epidermis involvement (19). Although Bowen's disease and actinic keratosis have been suggested to develop from different cell types, the approach and treatment of the patient are similar in practice (19). Because of these reasons, Bowen's disease and bowenoid actinic keratosis were evaluated as IsSCC without any discrimination in our study.…”