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Primary Cecal Squamous Cell Carcinoma: A Case Report of a Rare Tumor with Poor Prognosis. Case Rep Oncol Med 2021; 2021:6680702. [PMID: 34336321 PMCID: PMC8298140 DOI: 10.1155/2021/6680702] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Accepted: 07/04/2021] [Indexed: 11/23/2022] Open
Abstract
Squamous cell carcinoma of the colon is a rare tumor and primary cecal localization is unusual. This malignant condition is marked by a worst prognosis due to early local invasion. We report a case of a 46-year-old female patient admitted to the emergency department with symptoms of peritonitis. CT scan showed a cecal tumor perforated in the retroperitoneal space. The patient underwent right hemicolectomy with D2 lymphadenectomy without intestinal anastomosis. The diagnosis of squamous cell carcinoma was confirmed by histopathological examination. Squamous cell carcinoma is a malignant tumor with poor prognosis, hence, the interest of early diagnosis and management.
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2
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Abstract
Squamous cell carcinoma (SCC) is most commonly seen in the esophagus and anal canal in the gastrointestinal tract. The incidence of SCC of the rectum is infrequent with no clear etiology. There have been limited reported cases of SCC of the rectum caused by human papillomavirus (HPV). Due to the rarity of carcinoma, the management of SCC of the rectum is not standardized. We report a case of a 51-year-old female with an insignificant medical history presenting with hematochezia and weight loss and was found to have HPV-positive SCC of the rectum. This case report emphasizes the importance of work-up, usefulness of HPV testing for high-risk patients, and clinical management of SCC of the rectum.
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Affiliation(s)
- Shraddhadevi Makadia
- Internal Medicine, Ocala Regional Medical Center, University of Central Florida College of Medicine, Ocala, USA
| | - Ishan Patel
- Internal Medicine, Jersey Shore University Medical Center, Neptune, USA
| | - Khalid Abusaada
- Internal Medicine, Ocala Regional Medical Center, University of Central Florida College of Medicine, Ocala, USA
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3
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Synchronous Squamous Cell Carcinoma of the Anorectum and Proctosigmoid-a Case Report. Indian J Surg 2018; 80:77-80. [PMID: 29581689 DOI: 10.1007/s12262-017-1716-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Accepted: 12/08/2017] [Indexed: 10/18/2022] Open
Abstract
Primary squamous cell carcinoma of the rectum is extremely rare. Squamous cell carcinoma of the anorectum is a known entity evaluation and treatment protocols have been well defined. The occurrence of squamous cell carcinoma of rectosigmoid in concurrence with squamous cell carcinoma of the anal canal is extremely rare and the first case to be reported in the literature. A 48-year-old male patient presented with difficulty in passing stools. The clinical examination, colonoscopy, and the histopathology revealed synchronous proctosigmoid and the anorectal neoplasm. A case like this will pose a diagnostic challenges; squamous cell carcinoma of the rectum is not defined in the medical literature; synchronous squamous cell carcinoma will pose both diagnostic dilemmas and treatment challenges like whether to conserve the sphincter or not. Because squamous cell carcinoma of the anorectum can be treated by chemoradiotherapy, even this case is initially thought of treating by neoadjuvant chemoradiotherapy followed by low anterior resection followed by adjuvant treatment. Since there was no medical literature to support this treatment, ultimately multidisciplinary tumor board decision was made for abdominoperineal resection. Patient was treated with abdominoperineal resection and adjuvant chemoradiation. The diagnostic dilemmas and the management issues have been discussed.
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4
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Dikshit V, Ali I, Patil C, Manerikar K, Mody P. Squamous Cell Carcinoma of Colon-an Etiopathological Surprise. J Gastrointest Cancer 2018; 50:604-608. [PMID: 29417382 DOI: 10.1007/s12029-018-0072-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Vashisht Dikshit
- Department of Surgery, Dr. D. Y. Patil Medical College and Hospital, Sant Tukaram Nagar, Pimpri, Pune, 411018, India.
| | - Iqbal Ali
- Department of Surgery, Dr. D. Y. Patil Medical College and Hospital, Sant Tukaram Nagar, Pimpri, Pune, 411018, India
| | - Chandradip Patil
- Department of Surgery, Dr. D. Y. Patil Medical College and Hospital, Sant Tukaram Nagar, Pimpri, Pune, 411018, India
| | - Kshitij Manerikar
- Department of Surgery, Dr. D. Y. Patil Medical College and Hospital, Sant Tukaram Nagar, Pimpri, Pune, 411018, India
| | - Pratham Mody
- Department of Surgery, Dr. D. Y. Patil Medical College and Hospital, Sant Tukaram Nagar, Pimpri, Pune, 411018, India
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5
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Vyas N, Ahmad S, Bhuiyan K, Catalano C, Alkhawam H, Sogomonian R, Nguyen J, Walfish A, Aron J. Primary squamous cell carcinoma of the rectum: a case report and literature review. J Community Hosp Intern Med Perspect 2016; 6:31708. [PMID: 27406458 PMCID: PMC4942521 DOI: 10.3402/jchimp.v6.31708] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Revised: 06/13/2016] [Accepted: 06/15/2016] [Indexed: 12/19/2022] Open
Abstract
Squamous cell carcinoma (SCC) of the rectum is a rare occurrence with an incidence rate of 0.1–0.25% per 1,000 cases. Herein, we report a case of a 52-year-old female who presented with a 2-month history of diffuse lower abdominal pain and hematochezia. Abdominal CT scan revealed a 7-cm irregular rectal mass, and the biopsy showed SCC.
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Affiliation(s)
- Neil Vyas
- Department of Internal Medicine, Elmhurst Hospital Center, Elmhurst, NY, USA;
| | - Sumair Ahmad
- Department of Gastroenterology, Elmhurst Hospital Center, Elmhurst, NY, USA
| | - Khaled Bhuiyan
- Department of Internal Medicine, Wyckoff Heights Medical Center, Brooklyn, NY, USA
| | - Carmine Catalano
- Department of Internal Medicine, Elmhurst Hospital Center, Elmhurst, NY, USA
| | - Hassan Alkhawam
- Department of Internal Medicine, Elmhurst Hospital Center, Elmhurst, NY, USA
| | - Robert Sogomonian
- Department of Internal Medicine, Elmhurst Hospital Center, Elmhurst, NY, USA
| | - James Nguyen
- Department of Internal Medicine, Elmhurst Hospital Center, Elmhurst, NY, USA
| | - Aaron Walfish
- Department of Gastroenterology, Elmhurst Hospital Center, Elmhurst, NY, USA
| | - Joshua Aron
- Department of Internal Medicine, Elmhurst Hospital Center, Elmhurst, NY, USA
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6
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Guerra GR, Kong CH, Warrier SK, Lynch AC, Heriot AG, Ngan SY. Primary squamous cell carcinoma of the rectum: An update and implications for treatment. World J Gastrointest Surg 2016; 8:252-265. [PMID: 27022453 PMCID: PMC4807327 DOI: 10.4240/wjgs.v8.i3.252] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Revised: 11/03/2015] [Accepted: 01/22/2016] [Indexed: 02/06/2023] Open
Abstract
AIM: To provide an update on the aetiology, pathogenesis, diagnosis, staging and management of rectal squamous cell carcinoma (SCC).
METHODS: A systematic review was conducted according to the preferred reporting items for Systematic Reviews and Meta-Analyses guidelines. A comprehensive search of Ovid MEDLINE was performed with the reference list of selected articles reviewed to ensure all relevant publications were captured. The search strategy was limited to the English language, spanning from 1946 to 2015. A qualitative analysis was undertaken examining patient demographics, clinical presentation, diagnosis, staging, treatment and outcome. The quantitaive analysis was limited to data extracted on treatment and outcomes including radiological, clinical and pathological complete response where available. The narrative and quantitative review were synthesised in concert.
RESULTS: The search identified 487 articles in total with 79 included in the qualitative review. The quantitative analysis involved 63 articles, consisting of 43 case reports and 20 case series with a total of 142 individual cases. The underlying pathogenesis of rectal SCC while unclear, continues to be defined, with increasing evidence of a metaplasia-dysplasia-carcinoma sequence and a possible role for human papilloma virus in this progression. The presentation is similar to rectal adenocarcinoma, with a diagnosis confirmed by endoscopic biopsy. Many presumed rectal SCC’s are in fact an extension of an anal SCC, and cytokeratin markers are a useful adjunct in this distinction. Staging is most accurately reflected by the tumour-node-metastasis classification for rectal adenocarcinoma. It involves examining locoregional disease by way of magnetic resonance imaging and/or endorectal ultrasound, with systemic spread excluded by way of computed tomography. Positron emission tomography is integral in the workup to exclude an external site of primary SCC with metastasis to the rectum. While the optimal treatment remains as yet undefined, recent studies have demonstrated a global shift away from surgery towards definitive chemoradiotherapy as primary treatment. Pooled overall survival was calculated to be 86% in patients managed with chemoradiation compared with 48% for those treated traditionally with surgery. Furthermore, local recurrence and metastatic rates were 25% vs 10% and 30% vs 13% for the chemoradiation vs conventional treatment cohorts.
CONCLUSION: The changing paradigm in the treatment of rectal SCC holds great promise for improved outcomes in this rare disease.
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7
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Ballestero Pérez A, Abadía Barnó P, García-Moreno Nisa F, Die Trill J, Galindo Álvarez J. Primary squamous cell carcinoma of the rectum: an atypical histology. REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS 2016; 108:826-835. [PMID: 26911877 DOI: 10.17235/reed.2016.3975/2015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Squamous cell carcinoma of the rectum is one of the differential diagnoses of rectal tumors. It represents a low incidence in the population. The etiopathogenesis and the biology of these tumors are unclear, for this reason the gold standard treatment is difficult to establish. We present a 47-years-old woman who had a squamous cell carcinoma in medium rectum. She was treated with radiation therapy and chemotherapy and the treatment was followed by surgical excision.
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Affiliation(s)
| | - Pedro Abadía Barnó
- Cirugía General y Digestivo, Hospital Universitario Ramón y Cajal. Madrid, España
| | | | - Javier Die Trill
- Cirugía General, Hospital Universitario Ramón y Cajal. Madrid, españa
| | - Julio Galindo Álvarez
- Cirugía General y del Aparato Digestivo, Hospital Universitario Ramón y Cajal. Madrid, ESPAÑA
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8
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Unexpected Malignant Diagnosis in Colonic Biopsies: Malignant Transformation of Ovarian Mature Teratomas-Two Case Reports and Review of the Literature. Case Rep Pathol 2015; 2015:905462. [PMID: 26881165 PMCID: PMC4736194 DOI: 10.1155/2015/905462] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 12/02/2015] [Indexed: 12/04/2022] Open
Abstract
Colorectal adenocarcinoma is the second cause of cancer-related deaths in the United States. The occurrence of squamous cell carcinoma in the colorectum is extremely unusual. Malignant transformation from mature cystic teratoma of the ovary is a rare event. The most common transformation is squamous cell carcinoma, followed by adenocarcinoma. It occurs more often in elderly patients, who usually present with advance disease. We report two unusual cases of postmenopausal women diagnosed with squamous cell carcinoma in colon biopsies. After surgical resections, the carcinoma was proven to be the result of malignant transformation of ovarian mature cystic teratomas. Since squamous cell carcinoma of the colorectum is extremely rare, the presence of squamous cell carcinoma in a colonic biopsy in a female patient should alert the clinicians to other possible primary sites, as seen in these cases.
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9
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Sundriyal D, Shirsi N, Kotwal S, Dawar R. Squamous Cell Carcinoma of Rectum: How to Treat? Indian J Surg Oncol 2015; 6:300-2. [PMID: 27217685 DOI: 10.1007/s13193-015-0434-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2015] [Accepted: 06/15/2015] [Indexed: 11/27/2022] Open
Abstract
Squamous cell carcinoma (SCC) of rectum is an uncommonly seen malignancy. It has been difficult to establish the precise etio-pathogenesis due to paucity of cases. For the same reason, the rigorous treatment protocol has not been defined. The available compendium of knowledge about this pathology is based on isolated case reports and case series. We report a case of SCC of rectum who was treated with chemo-radiotherapy.
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Affiliation(s)
- Deepak Sundriyal
- Department of Medical Oncology, Dharamshila Hospital & Research Centre, Vasundhara Enclave, New Delhi, 110096 India ; 79 , Sector 12, Dwarka, New delhi 110078 India
| | - Nikhil Shirsi
- Department of Medical Oncology, Dharamshila Hospital & Research Centre, Vasundhara Enclave, New Delhi, 110096 India
| | - Sumedha Kotwal
- Department of Pathology, Dharamshila Hospital & Research Centre, Vasundhara Enclave, New Delhi, 110096 India
| | - Ramesh Dawar
- Department of Pathology, Dharamshila Hospital & Research Centre, Vasundhara Enclave, New Delhi, 110096 India
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10
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Musio D, De Felice F, Manfrida S, Balducci M, Meldolesi E, Gravina GL, Tombolini V, Valentini V. Squamous cell carcinoma of the rectum: The treatment paradigm. Eur J Surg Oncol 2015; 41:1054-8. [PMID: 25956212 DOI: 10.1016/j.ejso.2015.03.239] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Revised: 03/17/2015] [Accepted: 03/30/2015] [Indexed: 12/18/2022] Open
Abstract
PURPOSE This study was planned to clarify the optimal treatment for squamous cell carcinoma of the rectum, an histological entity extremely rare. METHODS Ten patients with histologically proven squamous cell carcinoma of the rectum were treated with concomitant radiochemotherapy. Radiation therapy was delivered with a 3Dconformational multiple field technique to a dose ranging from 45 to 76.5 Gy, with 6-15 MV energy photons. Chemotherapy consisted of an antimetabolite drug in association with mitomycin C or oxaliplatin. Overall survival and disease free survival were considered in months from the end of the concomitant treatment. RESULTS All patients completed programmed radiochemotherapy treatment but two patients were excluded to the analysis. Six patients (75%) presented negative biopsy 6 months after the end of radiochemotherapy. Seven patients (87.5%) showed a tumour regression after initial treatment. Only 1 patient underwent salvage surgery. Considering a mean follow-up of 41.75 months, 7 patients are still disease free survivors. Only 1 patient developed local recurrence at 6 months and he died 14 months after abdomino-perineal resection. CONCLUSION Primary radio chemotherapy, with a curative intent, could be considered the treatment modality of choice for squamous carcinoma of the rectum.
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Affiliation(s)
- D Musio
- Department of Radiotherapy, University of Rome "Sapienza", Viale del Policlinico 155, 00161, Rome, Italy.
| | - F De Felice
- Department of Radiotherapy, University of Rome "Sapienza", Viale del Policlinico 155, 00161, Rome, Italy
| | - S Manfrida
- Department of Radiotherapy, Universita Cattolica del Sacro Cuore, Largo A. Gemelli 8, 00168, Rome, Italy
| | - M Balducci
- Department of Radiotherapy, Universita Cattolica del Sacro Cuore, Largo A. Gemelli 8, 00168, Rome, Italy
| | - E Meldolesi
- Department of Radiotherapy, Universita Cattolica del Sacro Cuore, Largo A. Gemelli 8, 00168, Rome, Italy
| | - G L Gravina
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - V Tombolini
- Department of Radiotherapy, University of Rome "Sapienza", Viale del Policlinico 155, 00161, Rome, Italy
| | - V Valentini
- Department of Radiotherapy, Universita Cattolica del Sacro Cuore, Largo A. Gemelli 8, 00168, Rome, Italy
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11
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Rajan R, Baqar A, Menon T. An interesting case of primary squamous cell carcinoma of the colon with synchronous metastatic adenocarcinoma. Clin Case Rep 2014; 2:323-5. [PMID: 25548638 PMCID: PMC4270718 DOI: 10.1002/ccr3.127] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Revised: 05/20/2014] [Accepted: 05/20/2014] [Indexed: 12/15/2022] Open
Abstract
KEY CLINICAL MESSAGE We present a case of primary squamous cell carcinoma of the colon with synchronous metastatic adenocarcinoma. This case highlights the poor prognosis of these late presenting cancers. Furthermore, the unusual dual pathology raises questions about its potential etiology.
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Affiliation(s)
- Ruben Rajan
- Department of General Surgery, Royal Perth Hospital 197 Wellington Street, Perth, Western Australia, 6000, Australia
| | - Ali Baqar
- Department of General Surgery, Royal Perth Hospital 197 Wellington Street, Perth, Western Australia, 6000, Australia
| | - Tulsi Menon
- Department of General Surgery, Royal Perth Hospital 197 Wellington Street, Perth, Western Australia, 6000, Australia
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12
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Cho DK, Kim SH, Cho SB, Lee WS, Joo YE. [Primary squamous cell carcinoma of the ascending colon: report of a case and Korean literature review]. THE KOREAN JOURNAL OF GASTROENTEROLOGY 2014; 64:98-102. [PMID: 25168052 DOI: 10.4166/kjg.2014.64.2.98] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Primary squamous cell carcinoma of the colon is an extremely rare malignancy. A 48-year-old male visited our hospital for screening colonoscopy. Colonoscopic examination showed a 1 cm sized sessile polyp in the ascending colon. The patient underwent endoscopic mucosal resection (EMR) without any complication. The pathologic findings were compatible with squamous differentiation of tumor cells in inflammatory colonic mucosa. The tumor was confined to the mucosa and the margins of the excised tissue were found to be free of the tumor. There were no other primary sites and no distant metastases in the extensive evaluation using a whole body CT scan and PET-CT. Additional surgical resection was not done. Follow-up colonoscopy performed eight month later showed a whitish scar without evidence of local recurrence and follow-up PET-CT demonstrated no evidence of recurrence. Herein, we report a case of primary squamous cell carcinoma of the ascending colon presenting as a sessile polyp which was removed by EMR.
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Affiliation(s)
- Dong Keun Cho
- Department of Internal Medicine, Chonnam National University Medical School, 160 Baekseo-ro, Dong-gu, Gwangju 501-746, Korea
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13
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Ngo N, Edriss H, Figueroa JA, Nugent K. Squamous cell carcinoma of the sigmoid colon presenting with severe hypercalcemia. Clin Colorectal Cancer 2014; 13:251-4. [PMID: 25444465 DOI: 10.1016/j.clcc.2014.06.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2014] [Revised: 06/22/2014] [Accepted: 06/27/2014] [Indexed: 02/05/2023]
Affiliation(s)
- Nina Ngo
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX
| | - Hawa Edriss
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX.
| | - Jose A Figueroa
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX
| | - Kenneth Nugent
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX
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14
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Hogan NM, Leonard G, Sheehan M, Joyce MR. Early recurrence and progression of a rare rectal squamous cell carcinoma after initial response to primary chemoradiotherapy. TUMORI JOURNAL 2013; 99:e88-90. [DOI: 10.1177/030089161309900322] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Rectal squamous cell carcinomas represent an extremely rare malignancy which carries a significant morbidity and mortality. Diagnosis requires distinction from squamous cell carcinoma of the anus and colonic adenocarcinoma by endoscopy and histopathological examination of a biopsy. Due to the rarity of the pathology, available evidence is limited and optimum management has yet to be elucidated. Older reports favored radical surgical management, but recent reports in the literature recommend judicious use of primary chemoradiotherapy. We herein report the diagnosis and management of a male patient with an aggressive, locally advanced rectal squamous cell carcinoma treated with good results with primary chemoradiotherapy. Six months after completion of therapy, however, extensive recurrence and metastases were diagnosed. This case highlights the need for stringent clinical and radiological follow-up.
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Affiliation(s)
- Niamh M Hogan
- Department of Colorectal Surgery, University College Hospital Galway, Galway, Ireland
| | - Gregory Leonard
- Department of Oncology, University College Hospital Galway, Galway, Ireland
| | - Margaret Sheehan
- Department of Histopathology, University College Hospital Galway, Galway, Ireland
| | - Myles R Joyce
- Department of Colorectal Surgery, University College Hospital Galway, Galway, Ireland
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15
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p63-expressing cells are the stem cells of developing prostate, bladder, and colorectal epithelia. Proc Natl Acad Sci U S A 2013; 110:8105-10. [PMID: 23620512 DOI: 10.1073/pnas.1221216110] [Citation(s) in RCA: 171] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
The tumor protein p63 (p63), and more specifically the NH2-terminal truncated (ΔN) p63 isoform, is a marker of basal epithelial cells and is required for normal development of several epithelial tissues, including the bladder and prostate glands. Although p63-expressing cells are proposed to be the stem cells of the developing prostate epithelium and bladder urothelium, cell lineages in these endoderm-derived epithelia remain highly controversial, and rigorous lineage tracing studies are warranted. Here, we generated knock-in mice expressing Cre recombinase (Cre) under the control of the endogenous ΔNp63 promoter. Heterozygote ΔNp63(+/Cre) mice were phenotypically normal and fertile. Cre-mediated recombination in ΔNp63(+/Cre);ROSA26(EYFP) reporter mice faithfully recapitulated the pattern of ΔNp63 expression and were useful for genetic lineage tracing of ΔNp63-expressing cells of the caudal endoderm in vivo. We found that ΔNp63-positive cells of the urogenital sinus generated all epithelial lineages of the prostate and bladder, indicating that these cells represent the stem/progenitor cells of those epithelia during development. We also observed ΔNp63 expression in caudal gut endoderm and the contribution of ΔNp63-positive cells to the stem/progenitor compartment of adult colorectal epithelium. Because p63 is a master regulator of stratified epithelial development, this finding provides a unique developmental insight into the cell of origin of squamous cell metaplasia and squamous cell carcinoma of the colon.
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