Table sí Extramammary Paget's Disease
Diagnosis
Symptoms
Clinical appearance
Differential diagnosis
Therapy
Extramammary Pruritus, Paget's burning, disease bleeding
Red velvety lesions with white plaques
Melanoma (histologically), Paget's disease of urothelial or anorectal origin
Wide excision for noninvasive disease benignity to the clinician. These lesions are associated with HPV type 6 and 11 (62). There is often reactive induration of tissue adjacent to a verrucous carcinoma, as well as reactive lymphadenopathy, which may raise the clinical suspicion of metastatic disease (63). Pathological diagnosis may be difficult, as superficial biopsies may not
Figure 32 Squamous cell carcinoma of the vulva. (A) This is an example of an exophytic lesion. (B) (See color insert) This is an example of an endophytic lesion. (C) Typical appearance of squamous cell carcinoma, non-HPV-related type. Irregular tumor nests are invading the stroma, which is exhibiting a desmoplastic reaction. (D) In the non-HPV-related tumors, the lesions are often well differentiated and exhibit keratin pearls as demonstrated here. Abbreviation: HPV, human papilloma virus.
Figure 32 Squamous cell carcinoma of the vulva. (A) This is an example of an exophytic lesion. (B) (See color insert) This is an example of an endophytic lesion. (C) Typical appearance of squamous cell carcinoma, non-HPV-related type. Irregular tumor nests are invading the stroma, which is exhibiting a desmoplastic reaction. (D) In the non-HPV-related tumors, the lesions are often well differentiated and exhibit keratin pearls as demonstrated here. Abbreviation: HPV, human papilloma virus.
Table 32 Squamous Cell Carcinoma
Clinical
Diagnosis Symptoms appearance Differential diagnosis Therapy
Invasive None when Ulcerating or Basal cell carcinoma, Usually radical surgery, squamous cell carci-
small.
Pruritus and bleeding when large exophytic lesion keratoacanthoma, sexually transmitted diseases if ulcerative with possible adjuvant radiation therapy. Cryosurgery to the primary lesion has been reported in advanced disease noma
Figure 33 Verrucous carcinoma. (A) Lesions grossly appear large and warty. (B) Low-power view demonstrating the warty architecture. (C) Lesions show minimal atypia, and there may be human papilloma virus cytopathic changes. (D) These lesions exhibit a "pushing" border, in contrast to the invasive border seen in usual squamous cell carcinoma.
Figure 33 Verrucous carcinoma. (A) Lesions grossly appear large and warty. (B) Low-power view demonstrating the warty architecture. (C) Lesions show minimal atypia, and there may be human papilloma virus cytopathic changes. (D) These lesions exhibit a "pushing" border, in contrast to the invasive border seen in usual squamous cell carcinoma.
Clinical |
Differential | |||
Diagnosis |
Symptoms |
appearance |
diagnosis |
Therapy |
Verrucous |
Mass, pruritus |
Large exophytic |
Condyloma acuminatum, |
Wide local |
carcinoma |
warty mass |
squamous cell carcinoma |
excision |
include the deeper portions needed to histologically document invasion. The overall histology is similar to that of condyloma acuminatum, with minimal atypia, and possible koilocytosis, but verrucous carcinomas have a pushing invasive front. These lesions rarely metastasize. Radiation therapy has been reported to induce anaplastic change (Table 33) (59).
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Complete Guide to Preventing Skin Cancer. We all know enough to fear the name, just as we do the words tumor and malignant. But apart from that, most of us know very little at all about cancer, especially skin cancer in itself. If I were to ask you to tell me about skin cancer right now, what would you say? Apart from the fact that its a cancer on the skin, that is.
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