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14-September-2008 11:27:25 - in situ Carcinoma in situ CIS is an early form of carcinoma defined by the absence of invasion of surrounding tissues. In other words, the neoplastic cells proliferate in their normal habitat, hence the name 'in situ' Latin for 'in its place'. For example, carcinoma in situ of the skin, also called Bowen's disease is the accumulation of neoplastic epidermal cells within the epidermis only. For this reason, CIS will usually not form a tumor. Rather, the lesion is flat in the skin, cervix, etc or follows the existing architecture of the organ in the breast, lung, etc. Some CIS, however, form tumors, for example colon polyps or papillary cancer of the bladder. Many forms of invasive carcinoma the most common form of cancer originate from a CIS lesion. Therefore, CIS is considered a precursor or incipient form of cancer that may, if left untreated long enough, transform into a malignant neoplasm. When explaining a laboratory report to a patient, most doctors will refer to CIS as pre-cancer, not cancer. However, because most forms of CIS have a real potential to turn into invasive carcinoma, doctors will usually recommend that the lesion be completely removed. Therefore, CIS is usually treated much the same way as a malignant tumor. In the TNM classification, carcinoma in situ is indicated as TisN0M0 Stage 0. Contents 1 Dysplasia vs carcinoma in situ vs invasive carcinoma 2 Examples of carcinomata in situ 3 Treatment 4 See also Dysplasia vs carcinoma in situ vs invasive carcinoma These terms are related since they represent the three steps of the progression toward cancer: Dysplasia from the Greek δυσπλασία malformation, δυσ- mal- + πλάθω to create, to form, is the earliest form of pre-cancerous lesion recognizable in a biopsy by a pathologist. Dysplasia can be low grade or high grade see CIS below. The risk of low-grade dysplasia transforming into cancer is low. Carcinoma in situ is synonymous with high-grade dysplasia in most organs. The risk of transforming into cancer is high. Invasive carcinoma, commonly called cancer, is the final step in this sequence. It is a disease that, when left untreated, will invade the host hence its name and may be lethal. Examples of carcinomata in situ Many bladder cancers are CIS. Cervical cancer is often predated by cervical squamous intraepithelial lesion SIL, previously CIN, a form of dysplasia. The term CIS is not used for the cervix. Instead, the term high grade SIL HSIL is used, essentially a synonym. It is this lesion that is detected with the pap smear. Ductal carcinoma in situ DCIS of the breast is a rather frequent disease with a high probability of transforming into true breast cancer if untreated. Bowen's disease is squamous carcinoma in situ of the skin. Colon polyps often contain areas of CIS that will almost always turn into colon cancer if left untreated. High grade Prostatic intraepithelial neoplasia is equivalent to CIS of the prostate. Bronchioloalveolar carcinoma of the lung is the only form of CIS that can kill because it fills the lungs and prevents breathing. Thus, it is malignant, but not invasive. For this reason, this unusual form of carcinoma is seen as CIS by pathologists, not by oncologists or surgeons. Therefore, its inclusion among the CIS category is controversial. High grade dysplasia carcinoma in situ in the uterine cervix. The abnormal epithelium is extending into a mucus gland to the left of centre. This disease can progress to invasive cancer squamous cell carcinoma of the cervix. High grade dysplasia carcinoma in situ in the uterine cervix. The abnormal epithelium is extending into a mucus gland to the left of centre. This disease can progress to invasive cancer squamous cell carcinoma of the cervix. Treatment Carcinoma in situ is, by definition, localized, with no potential for metastasis unless it progresses into a true cancer. Therefore, its removal eliminates the risk of cancer. It can be compared to uprooting a tree, easy when a young sapling, more difficult later. Some forms e.g. colon polyps and polypoid tumors of the bladder can be removed using an endoscope, without true surgery. Dysplasia of the uterine cervix is removed by excision cutting it out or by burning with a laser. Bowen's disease of the skin is removed by excision. Other forms of CIS require major surgery, the best known being Intraductal carcinoma of the Breast. The most difficult form of CIS is Bronchioloalveolar carcinoma of the Lung, which requires the removal of large parts of the lung. When too large, it cannot be removed and often kills its host. Intraductal carcinoma of the Breast is also treated with radiotherapy. See also Cancer Neoplasia Dysplasia Carcinoma v d e Pathology: Tumor, Neoplasm, Cancer, and Oncology C00-D48, 140-239 Benign tumors Hyperplasia - Cyst - Pseudocyst - Hamartoma - Benign tumor Malignant progression Dysplasia - Carcinoma in situ - Cancer - Metastasis Topography Oral - Head/Neck - Nasopharyngeal - digestive system - Respiratory system - Bone - Skin - Blood - Urogenital - Nervous system - Endocrine system Histology Carcinoma - Sarcoma - Papilloma - Adenoma Misc. Tumor suppressor genes/oncogenes - Staging/grading - Carcinogenesis - Carcinogen - Research - Paraneoplastic syndrome - List of oncology-related terms Retrieved from http://en..org/wiki/Carcinoma_in_situ Categories: Histopathology | Types of cancer Views Article Discussion this page History Personal tools Log in / create account Navigation Main page Contents Featured content Current events Random article Search Go Search Interaction Community portal Recent changes Contact Donate to Help Toolbox What links here Related changes Upload file Special pages Printable version Permanent link Cite this page Languages العربية Deutsch Español Italiano Nederlands Português РуÑ?Ñ?кий This page was last modified on 30 August 2008, at 16:37
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