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An Official Publication of the Indian Association of Oral and Maxillofacial Pathologists


 
CASE REPORT - EPITHELIAL MALIGNANCIES Table of Contents   
Year : 2019  |  Volume : 23  |  Issue : 4  |  Page : 87-89
Pseudovascular squamous cell carcinoma with eosinophil-rich stroma


Loma Linda University Medical Center, Loma Linda, CA, USA

Correspondence Address:
Yamil Lopez
Department of Pathology, Loma Linda University Medical Center, 11234 Anderson Street, Room 2516, Loma Linda, CA 92354
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jomfp.JOMFP_276_18

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Pseudovascular squamous cell carcinoma (SCC) is a rare variant of SCC characterized by acantholysis and necrosis with preservation of vascular-like cords and spaces mimicking glands or vascular differentiation. Only three cases of this variant in the oral cavity have been reported in the literature. However, none of these cases were eosinophil-rich, which is considered to be a good prognostic indicator for conventional SCC. We report one case of an eosinophil-rich pseudovascular adenoid SCC in the oral cavity. A 38-year-old previously healthy African-American female presented with an enlarging inner left cheek mass with overlying ulcer of 2 months duration. A computed tomography scan with contrast demonstrated a large irregularly outlined peripherally enhancing mass located between the anterior margin of the ramus of the left mandible and maxilla protruding outward. An incisional biopsy was performed followed by a wide local excision 3 weeks later. She recovered well postoperatively but refused to follow-up chemoradiation therapy. Six months later, she presented with altered mental status secondary to hypercalcemia from bony metastases. She was discharged to a hospice facility as per her family's request. Histologic sections of the specimens revealed a diffuse hypercellular pleomorphic ill-circumscribed lesion with extensive necrosis. The viable areas exhibited slit vascular-like spaces and micropapillary architectural patterns with stromal eosinophilia. Focal small cellular nests with features of SCC were present. Immunohistochemistry displayed positivity for vimentin, p53, AE1/AE3 and CAM 5.2 (focally positive). All tumor cells were negative for desmin and CD34.


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Journal of Oral and Maxillofacial Pathology | Published by Wolters Kluwer - Medknow
Online since 15th Aug, 2007