Carcinoma in situ

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Carcinoma in situ

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

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 cancer originate from a 'carcinoma in situ' (CIS) lesion. Therefore, CIS is considered a precursor that may, if left untreated long enough, transform into a more malignant form of neoplasm, invasive carcinoma or, in common language, "cancer".

Many doctors will not refer to 'carcinoma in situ' as "cancer" when explaining a laboratory report to a patient. However, because most forms of CIS have a real potential to turn into invasive carcinoma, CIS is usually treated much the same way as a malignant tumor.

In the TNM classification, carinoma in situ is indicated as TisN0M0 (Stage 0).

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 high-grade dysplasia and, eventually, cancer is low. Treatment is usually easy.
  • Carcinoma in situ is synonymous with high-grade dysplasia in most organs. The risk of transforming into cancer is high. Treatment is still usually easy.
  • 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 will probably kill them. It can often, but not always, be treated successfully.

Examples of carcinomata in situ

Related chapters


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