Papillary squamous neoplasms of the head and neck

Abstract

Papillary squamous neoplasms of the upper respiratory tract are rare variants of squamous cell carcinoma and are related temporally to proliferative verrucous leukoplakia. Fifty-two cases of papillary squamous neoplasms were selected from 2366 cases of squamous cell carcinoma. This is the first study to characterize the biological behavior of papillary squamous neoplasms. Papillary squamous neoplasms exhibit two distinct, yet sometimes overlapping, histologic patterns including an exophytic papillary and an inverting verrucous morphologic appearance. A high rate of synchronous or metachronous lesions were found, especially with the inverting-type of papillary squamous neoplasm. Stage T3 and T4 lesions had a high rate of neck metastasis. Early surgical intervention and close long-term follow-up is mandatory.

Papillary squamous cell carcinomas of the upper aerodigestive tract: A clinicopathologic and molecular study

“…The lesion described in our study does not bear resemblance to that illustrated in their report. 2 The latter appear to be more consistent with verrucous and exophytic conventional squa- mous cell carcinomas arising in a proliferative verrucous leukoplakia. Moreover, the preponderance of tumors in oral cavity sites (alveolar ridge, buccal mucosa, floor of the mouth/ventral tongue, and retromolar trigone) in their study is unlike the sites of papillary carcinoma seen in our patients.…”

“…1 More important, however, is a continuing imprecision of diagnosis and definition of this type of carcinoma with an inclusion under the rubric of lesions such as verrucous carcinoma and exophytic conventional squamous cell carcinoma. 2,3 Also unclear is a putative role played by human papilloma virus (HPV) in the oncogenesis of papillary carcinomas and, in that light, identification of precursor lesions, if any. 4,5 Using histomorphologic criteria for papillary squamous cell carcinoma articulated by Batsakis et al, 6 Crissman et al, 1 and Thompson et al, 3 this report presents the clinicopathologic characteristics of papillary squamous cell carcinoma and findings that associate it with HPV infections and abnormalities of p53 protein.…”

Not Your Usual Cancer Case: Variants of Laryngeal Squamous Cell Carcinoma

“…Of the 22 patients in a series by Ishiyama et al (neoplasms they termed ''exophytic papillary squamous neoplasms''), only 3 (13%) of patients had disease recurrence, 1 (4.5%) had nodal metastasis, and no patient died of disease [22]. By contrast, though, in other series by Jo et al [20] and Suarez et al [21] the clinical behavior has been somewhat more akin to keratinizing SCC.…”

“…Morphologically, papillary SCC will have diffuse, marked, cytologic atypia whereas squamous papilloma with dysplasia or carcinoma will show it to be focally developing out of a background, non-dysplastic papilloma. Finally, mixed histologic patterns of benign papillomas along with the papillary SCC have only been reported in a handful of patients with papillary SCC [21,22]. [20] cases across all head and neck sites and HPV types.…”

Papillary squamous cell carcinoma of the oral mucosa: immunohistochemical comparison with other carcinomas of oral mucosal origin.

“…VCs containing areas that are indistinguishable from SCC have been described in the literature, and such tumors are called hybrid carcinomas (6,8). Ishiyama et al suggested that these hybrid carcinomas are probably identical to PSCC (7). The relationship of PSCC to HPV is unclear.…”