Squamous Cell Carcinoma with Monster Cells

Considering all the Monster cells, the Giant cells, the Natural Killer cells, and the Ghost cells, histopathology is scary business.  Of course I cannot identify the Natural Killer cells on H&E stained sections, I include them in my list because they sound so fierce.  If you can identify them without immunohistochemistry, you have superNatural sKills.  This biopsy shows a squamous cell carcinoma and the marked atypia and pleomorphism of the ‘monster” cells is quite interesting.  More than the usual degree of atypia anyway.  I included more high magnification shots so you can get up close with these monstrosities.  

 I admit, I missed the timing on this post and should have saved it for Halloween.

Reference

Basaloid squamous cell carcinoma with ‘monster’ cells: a mimic of pleomorphic basal cell carcinoma. Defty CL, Segen J, Carter JJ, Ahmed I, Carr RA. J Cutan Pathol. 2011 Apr;38(4):354-6.

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3 responses to “Squamous Cell Carcinoma with Monster Cells

    • I think in this lesion, since it is so superficial, it probably has no prognostic significance. If it were deeply invasive I would be concerned about increased risk for recurrence or metastatic potential, but maybe just the same as other poorly differentiated squamous cell carcinomas with less nuclear pleomorphism.

  1. Nice case Neil and wonderful to see our paper cited. I think our lesion was a follicular variant of SCC and yours has many of the hall-marks. Our case metastasised to the lymph nodes in the axilla a few months after it appeared in the journal and we are yet to add a letter! We are currently writing up 100+ cases of follicular SCC but that was the only one with pleomorphic monster cells I have seen. Many follicular SCC are missed currently.
    Regards Richard Carr, Warwick UK
    richard.carr@swft.nhs.uk

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