ADENOID SQUAMOUS CELL CARCINOMA OF THE SKIN OVERLYING THE RIGHT BREAST: An Autopsy Case Clinically Manifested with Rapid Growth and Widely Spreading Metastases

Abstract

An autopsy case of a 62-year-old woman with a poorly differentiated, aggressive form of adenoid squamous cell carcinoma arising in the skin overlying the right breast was studled. The tumor, 9 x 8 cm in diameter, had rapidly enlarged since one year before admission from a verrucous lesion of 20 years duration. The histologic features of the tumor showed a welldifferentiated squamous cell carcinoma mainly in the superficial areas, which transformed into, with a zone of transition in between, an alveolar or adenoid structure in the deep invading portion. The adenoid tumor cells exhibited an undifferentiated appearance with prominent nucleoli and frequent mitotic figures. These cells partly showed dyskeratotic or acantholytic features. Much was negative. The patient died at 8 months after the operation.Autopsy revealed widely spreading metastases in which an adenoid structure was outstanding. These unusual pathological features and an aggressive behavior of this tumor, which were hitherto rarely described for adenoid squamous cell carcinoma, seemed to be a poorly differentiated variant of the tumor. This malignant transformation might be derived from loss of cohesion of the pre-existing usual well-differentiated squamous cell carcinoma in the basal and parabasal layers, inparting marked invasiveness of these cells into the supporting connective tissue. ACTA PATHOL.

Adenoid (acantholytic) squamous cell carcinoma of the skin

“…Since that time. Lever's postulate has been accepted widely, as supported by several other histopathologic and ultrastructural analyses of eutaneous ASCC (1,3,(9)(10)(11)(12). The large series on ASCC by Johnson and Helwig (155 cases) (3) was instrumental in estabhshing the clinieopathologic features of this lesion.…”

“…Nevertheless, several cases subsequently have been described in other clinical settings, including the vulva (10, 13), penis (11), oral mucosa (14-16), nasopharynx (17), and breast (18), in young adults or middle-aged patients of both sexes. Some of the latter tumors behaved aggressively (11,12,18), possibly owing to these atypieal topographie and epidemiologie associations.…”

Acantholytic squamous cell carcinoma of the lung with marked lymphogenous metastases and high titers of myeloperoxidase-antineutrophil cytoplasmic antibodies: a case report

“…Considering that acantholytic tumor cells can be seen along the invasive front of SQCC [ 40 , 44 ], the poorly differentiated SQCC component of the primary tumor may be a source of the acantholytic tumor cells in the present case. In addition, our case showed metastatic lymph nodes containing acantholytic tumor cells with foci of well to poorly differentiated SQCC, with or without keratin pearls, despite the primary tumor showing a paucity of keratin formation.…”

Carcinome épidermoïde du sein: à propos d’un cas et revue de la littérature

“…Cliniquement, il se présente sous forme d'une masse mammaire dont la taille moyenne est de 5 cm avec des extrêmes de 2 à 16 cm. Par ailleurs, les tumeurs de grande taille tendent à subir une dégénérescence kystique centrale avec envahissement et ulcération de la peau en regard, ce qui rend parfois difficile la distinction entre carcinome épidermoïde mammaire primitif et secondaire [ 3 , 4 ]. Radiologiquement, l'aspect n'est pas spécifique.…”