scirrhous

Scirrhous describes a tissue or tumor that is very hard due to a dense fibrous stroma produced by the tumor, often through a desmoplastic reaction. The term derives from the Greek skirrhos, meaning hard.

In pathology, scirrhous denotes tumors with abundant fibrous connective tissue and relatively little cellularity, especially at the invasive front. This fibrous stroma can cause the mass to feel firm or rock-hard and may lead to fixation to surrounding structures. Histologically, there is extensive collagen deposition and activated fibroblasts, with tumor cells infiltrating the surrounding tissue amid the desmoplastic reaction.

Clinically, the designation is most commonly applied to certain carcinomas that elicit a desmoplastic response, such as scirrhous carcinoma of the breast and scirrhous gastric carcinoma. In the stomach, the diffuse form of scirrhous carcinoma is associated with linitis plastica, a thickened, leathery stomach wall. Scirrhous tumors can constrict luminal spaces and alter organ mobility, and their fibrous stroma can complicate surgical resection and local control. Prognosis varies with cancer type and stage but is often influenced by the extent of invasion and desmoplasia.

Diagnosis relies on histopathologic assessment, supported by imaging studies that reveal a firm, infiltrative mass with thickened walls or organs. Treatment follows the standard regimens for the underlying cancer type, with attention to the implications of dense fibrous stroma for surgical planning and therapeutic delivery. See also desmoplasia and desmoplastic reaction.