Papillary Squamous Cell Carcinoma

The second most common form of skin cancer in the United States, squamous cell carcinoma (SCC) accounts for approximately 15 percent of all cases. Papillary squamous cell carcinoma is an unusual variant of SCC that is characterized by a unique papillary growth pattern. When viewed under a microscope, the tumors have long, thin, finger-like projections.

Most squamous cell skin cancers—including papillary squamous cell carcinoma—can be easily and successfully treated with current therapies. In all cases, early detection is the key to achieving the best possible outcome and quality of life.

Papillary squamous cell carcinoma causes and risk factors

Papillary squamous cell carcinoma is highly uncommon and not well understood. The results of some research studies suggest a causal relationship between human papillomavirus (HPV) infection and papillary squamous cell carcinoma. However, scientists have not yet confirmed this finding.

Like most skin cancers, papillary squamous cell carcinoma can result from skin damage caused by exposure to harmful ultraviolet (UV) light from the sun or indoor tanning devices. UV light can damage DNA in the squamous cells in the skin’s outermost layer, causing the cells to multiply very rapidly. The abnormal cells then build up, bind together and form tumors.

In addition to UV light exposure and possibly HPV infection, other risk factors for papillary squamous cell carcinoma include:

• Fair skin, light-colored eyes or naturally red or blonde hair
• A history of blistering sunburns or skin cancer
• Precancerous skin growths (actinic keratoses)
• Cigarette smoking
• Human immunodeficiency virus (HIV) infection
• A weakened immune system
• An inherited condition that interferes with the body’s natural ability to repair skin damage (xeroderma pigmentosum)

Papillary squamous cell carcinoma signs and symptoms

All types of squamous cell skin cancer—including the papillary subtype—often develop on skin that has been damaged by sun exposure or indoor tanning. Common sites include the face, lips, scalp, ears and hands. Early signs of sun damage include skin discoloration, age spots, loss of firmness and wrinkles.

The symptoms of papillary squamous cell carcinoma can include:

• Roughened, reddish or scaly skin patches
• An open sore with a raised border that does not heal
• A brown skin spot that resembles an age spot
• A firm, dome-shaped skin lesion
• A wart-like skin bump
• A tiny, rhinoceros-horn-shaped skin growth
• A new sore in an old scar

Skin cancer growths may be pink, red, purple, gray, brown, black or white.

Papillary squamous cell carcinoma diagnosis

A biopsy is the only way to confirm or rule out a skin cancer diagnosis. During this in-office procedure, a physician numbs the area around the suspicious skin growth, then removes all or part of it.

A pathologist then examines the removed tissue under a high-powered microscope. When the examination is complete, the pathologist prepares a report detailing the results, including whether any cancerous cells were found and, if so, the type of cancer and whether it has aggressive features. Papillary squamous cell carcinoma cells can be identified by their tiny papillae, which are distinctive finger-like structures that protrude from their surface.

Papillary squamous cell carcinoma treatment

When found early and treated appropriately, most cases of papillary squamous cell carcinoma can be cured. Sometimes, the cancerous cells can be completely removed during a biopsy and no further treatment is needed.

For a carcinoma that has grown deep into the skin or nearby tissues, treatment options may include:

• A surgical procedure, such as Mohs surgery, curettage and electrodessication, cryosurgery or laser surgery
• Radiation therapy, such as electronic skin surface brachytherapy (ESSB)
• Topical chemotherapy
• Photodynamic therapy surgery

Benefit from world-class care at Moffitt Cancer Center

The multispecialty team in Moffitt’s highly acclaimed Cutaneous Oncology Program offers the latest screening, diagnostic and treatment options for all types of skin cancer, including rare and complex variants such as papillary squamous cell carcinoma. Because these experienced surgeons, radiation therapists, dermatologists and dermatopathologists work exclusively with skin cancer patients, they have acquired refined expertise and are uniquely qualified to determine the most promising treatment for each patient.

If you have questions about skin cancer in general or papillary squamous cell carcinoma in particular, you can talk with a specialist at Moffitt without a referral. Request an appointment by calling 1-888-663-3488 or submitting a new patient registration form online.