Histologic Variants of Squamous Cell Carcinoma of the Skin

Margaret H. Rinker, MD; Neil A. Fenske, MD; Leigh Ann Scalf, MD, and L. Frank Glass, MD, Division of Dermatology and Cutaneous Surgery, Department of Internal Medicine at the University of South Florida, Tampa, Fla.

Cancer Control. 2001;8(4) 

In This Article

Signet Ring Squamous Cell Carcinoma

A case of signet ring SCC was first described by Cramer and Heggeness[34] in 1989. A second case was reported by McKinley et al[35] in 1998. Signet ring cells typically have nuclear displacement and compression by cytoplasmic contents. They have been described in a variety of tumors,including adenocarcinomas, lymphomas,melanomas, and sarcomas.

Clinically, the lesions appeared as an ulcerated plaque or nodule.The histology demonstrated intraepidermal and invasive dermal cells characterized by a signet ring appearance. The diagnosis of SCC could be easily overlooked in this situation. Fortunately, in one case,the tumor arose in a site previously diagnosed as SCC, and in the other case, there were foci of typical SCC. This prompted the inclusion of keratin stains, which were positive.[34,35]

With only two cases having been reported, it is impossible to determine its biologic behavior. In one case, the tumor behaved in an aggressive manner with extensive local invasion and lymph node metastasis, leading to death.[34] Further cases are needed to determine its true biologic behavior.

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