Microinvasive Squamous Cell Carcinoma

ICD-O:8076/3

Microinvasive squamous cell carcinoma (SCC) is a SCC with invasion beyond the epithelial basement membrane, extending into the superficial stroma. There is little consensus among pathologists on the maximum depth of invasion in microinvasive SCCs, but it generally ranges from 0.5 mm [20] to 2 mm [77]. The depth of invasion must be measured from the basement membrane of the adjacent (non-neoplastic) surface epithelium, because of the great variations in epithelial thickness.

Microinvasive SCC is a biologically malignant lesion capable of gaining access to lymphatic and blood vessels, which may result in metastases. However, metastases are rare in microinvasive SCCs and the prognosis is excellent. Studies on SCCs of the floor of the mouth have shown that there is little or even no metastatic potential for SCCs penetrating less than 2 mm beyond the basement membrane, and a substantially higher risk of metastases in more deeply invasive SCCs at this site [74, 77, 246]. The prognosis is also excellent in microinvasive SCCs of the laryngeal glottis because of the poor lymphatic and vascular network in this location. Some authors have therefore recommended more conservative treatment of these lesions, such as endoscopic removal, with a careful follow-up [80, 308, 341].

The reliable diagnosis of microinvasive SCC can only be made with certainty if the whole lesion is examined. It should not be made in small, tangentially cut biopsy specimens.

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