Abstract
Acantholytic squamous cell carcinoma (ASCC) was first described under title of “adeno-acanthoma of sweat glands” by Lever in 1947. Today it recognizes one type of the squamous cell carcinoma. The tumor commomly occurred in exposed areas, particularly near the head and neck regions in elderly persons. The microscopic feature of ASCC is acantholysis with formation of lumens containing dyskeratotic cells toward the center of the lobule. Johnson et al. reported there was metastasis in 3 patients among 155 patients. But Nappi et al. described cases did metastasize widely and prove fatal were 19%. The tumor size of greater than 1.5 cm correlate with the risk of an adverse outcome. We had experienced a case of 80-year-old male who had raised tumor on the left palm and one year after first operation he was dead to metastasize lymphnode of axilla, liver, kidney and costal bone. Histological finding of palm's tumor showed acantholysis with the lumens containing dyskeratotic cells. But lymphnode's histology showed adenoid carcinoma pattern. Further immunohistochemical examination proved metastatic cells in lymphnode was ASCC. We have discussed the importance of early surgical treatment and lymphnode dissection of ASCC compared with SCC. [Skin Cancer (Japan) 2000; 15: 108-112]
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