Abstract
Acantholytic squamous cell carcinoma (AcSCC) is a rare variant of poorly differentiated oral SCC of aggressive behavior that contains marked acantholysis, resulting in an adenoid appearance. A 58-year-old man presented an extensive painful and necrotic mass affecting the lower lip mucosa and skin, which appeared ulcerated and hardened for the last 5 months. The patient's cervical lymph nodes were palpable, and previous heavy tobacco use was reported. Intraoral examination showed an 8 × 6 cm ulcerated mass affecting lower anterior alveolar ridge with extension to the floor of the mouth and anterior mandible, which was completely destroyed in the image of panoramic radiograph. An incisional biopsy was performed, and microscopically, infiltrative malignant nests containing many acantholytic and dyskeratotic squamous cells were observed. The final diagnosis was of AcSCC, and the patient was referred for treatment. Oral AcSCC may appear as an exuberant infiltrative mass causing extensive bone destruction.
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