vesical squamous cell carcinoma

Squamous cell carcinoma of the bladder comprises less than 5% of all bladder cancers in the United States.

Risk factors associated with the development of bladder squamous cell carcinoma include long-term catheterization, a nonfunctioning bladder, urinary tract calculi, and chronic infection with Schistosoma hematobium.

In addition, morphologic changes that may herald the ultimate development of bladder squamous cell carcinoma have been reported to include:
 keratinizing squamous metaplasia
 verrucous squamous hyperplasia
 condyloma acuminatum
 squamous cell carcinoma in situ.

Cytogenetics

Many prior studies have focused predominantly or exclusively on schistosomal-related squamous cell carcinoma, which seem to harbor different molecular changes than nonschistosomal cancers present in developed countries.

Prognosis

In regions where schistosomal infection is not endemic, pure squamous cell carcinoma is an uncommon variant that has previously been described as a highly aggressive tumor with poor patient outcomes.

Many of the prior studies that have documented these findings, however, have been based predominantly on small biopsy or transurethral resection (TUR) specimens, in which large portions of the tumor were not assessed for additional subtypes of bladder carcinoma or included tumors of mixed morphologies.

In addition, many patients in earlier studies underwent radiation therapy rather than radical cystectomy after a diagnosis of squamous cell carcinoma, with poor outcomes.

One recent study of patients undergoing radical cystectomy, however, has suggested that patients with pure squamous cell carcinoma of the bladder seem to have outcomes similar to those of invasive urothelial carcinoma, including a 5-year disease specific survival rate of 57%.

Squamous cell carcinoma often presents at an advanced stage; however, radical cystectomy with lymph node dissection appears to offer a significant benefit in survival in a subset of patients. (18043032)

Etiology

Squamous cell carcinoma of the urinary bladder is unusual and of unknown etiology.

HPV does not play a role in the development of squamous cell carcinoma of the urinary bladder or urothelial carcinoma with squamous differentiation.

p16 expression should not be used as a surrogate marker for evidence of HVP infection in either squamous cell carcinoma of the urinary bladder or urothelial carcinoma with squamous differentiation as neither HVP DNA nor protein is detectable in these neoplasms. (22684221)

References

 p16 expression is not associated with human papillomavirus in urinary bladder squamous cell carcinoma. Alexander RE, Hu Y, Kum JB, Montironi R, Lopez-Beltran A, Maclennan GT, Idrees MT, Emerson RE, Ulbright TM, Grignon DG, Eble JN, Cheng L. Mod Pathol. 2012 Jun 8. PMID: 22684221

 Lagwinski N, Thomas A, Stephenson AJ, Campbell S, Hoschar AP, El-Gabry E, Dreicer R, Hansel DE. Squamous Cell Carcinoma of the Bladder: A Clinicopathologic Analysis of 45 Cases. Am J Surg Pathol. 2007 Dec;31(12):1777-1787. PMID: 18043032