Acantholytic squamous cell carcinoma is usually associated with hair follicles, not acantholytic actinic keratosis, and is not “high risk”: Diagnosis, management, and clinical outcomes in a series of 115 cases - 18/04/17
Abstract |
Background |
Acantholytic squamous cell carcinoma (aSCC) is regarded as a high-risk variant of cutaneous squamous cell carcinoma (SCC). Acantholytic actinic keratosis (aAK) has been regarded as a precursor risk factor for aSCC. However, supporting evidence is limited.
Objective |
We sought to document clinical features, histologic features, management, and outcomes in a series of aSCC cases.
Methods |
Definitions of aSCC, aAK, and aSCC arising in association with aAK were applied to a consecutive series of aSCC cases. Clinical characteristics and outcomes were obtained from electronic medical records.
Results |
Of 115 aSCC cases (103 patients, mean age 71.8 years), actinic keratosis was present in 23% (27/115) but only 7.8% (9/115) exhibited associated aAK. Ten cases (10/115, 9%) fulfilled strict histologic criteria for follicular SCC as previously defined, but 50 of 115 (43%) of our aSCC cases exhibited predominant involvement of follicular epithelium rather than epidermis. Clinical outcome (median follow-up, 36 months) was available in 106 of 115 (92%). One patient experienced regional extension (parotid), and 1 patient experienced a local recurrence (nose). No disease-related metastases or deaths were documented.
Limitations |
This was a single-institution retrospective study from the United States.
Conclusions |
The presence of acantholysis in cutaneous SCC does not specifically confer aggressive behavior, a finding that may inform clinical practice guidelines.
Le texte complet de cet article est disponible en PDF.Key words : acantholysis, acantholytic actinic keratosis, cutaneous oncology, dermatopathology, follicular squamous cell carcinoma, nonmelanoma skin cancer, outcomes, prognosis, squamous cell carcinoma
Abbreviations used : aAK, AK, aSCC, EORTC, KA, NCCN, SCC
Plan
| Dr Kiuru's involvement in this research was in part supported by the National Cancer Institute, National Institutes of Health, through grant K12CA138464. |
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| Conflicts of interest: None declared. |
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| Reprints not available from the authors. |
Vol 76 - N° 2
P. 327-333 - février 2017 Retour au numéro
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