title: Acute epithelioma--an aggressive squamous cell carcinoma of the skin.
abstract: This report describes an aggressive squamous cell carcinoma of the skin for which we suggest the name acute epithelioma. It is frequently larger than 2 cm and has a characteristic morphology with raised, rolled, vascular but not everted edges. Commonly there is a central crust covering a foul discharge on a papilliferous base. The biopsy is characteristically ambiguous but often that of a well differentiated squamous cell carcinoma. Irrespective of the history, which is usually short, all tumors have a period of rapid growth. Among 193 patients with squamous cell carcinomas of the eyelids or external ear, 24 (12%) of the tumors were designated as being acute epitheliomas. For the eyelids 15/125 (12%) patients were in this group; 10 (67%) had tumors larger than 2 cm, five (33%) developed regional metastases, and three (20%) had tumor related deaths. Irradiation controlled the primary tumor in 15 (100%) patients. Among the 68 ear tumors, nine (13%) were called acute epitheliomas. Eight (89%) were larger than 2 cm, three (33%) developed regional metastases, and two (22%) patients had tumor related deaths. Irradiation controlled the primary tumor in seven (78%) patients. It is postulated that these acute epitheliomas are virus induced tumors that develop in actinicly damaged and immunologically suppressed skin. Following treatment, careful follow-up is recommended because of their metastatic and lethal potential.
mesh_terms: D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000473:pathology* / Q000532:radiotherapy / Q000556:secondary; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000532:radiotherapy / Q000556:secondary; D004428:Ear Neoplasms / Q000473:pathology* / Q000532:radiotherapy; D005142:Eyelid Neoplasms / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery