title: Invasive cutaneous squamous cell carcinoma associated with actinic keratosis: a case with orbital invasion and meningeal infiltration.
abstract: BACKGROUND
  It is suggested that most squamous cell carcinomas in sun-exposed areas arise from preexisting solar keratosis. Actinic keratosis is thought of as being a precursor to squamous cell carcinoma. This form of squamous cell carcinoma has been considered to be a relatively benign lesion. We report a case of invasive squamous cell carcinoma associated with actinic keratosis leading to orbit destruction and meningeal infiltration.
  
  
  OBJECTIVE
  To demonstrate that well-differentiated tumors can act extremely aggressively with the potential toward infiltrative growth patterns.
  
  
  METHODS
  Histologically controlled surgery along with multiple radiation therapy was performed.
  
  
  RESULTS
  The tumor progressed inducing perineural invasion, orbit infiltration, osseous destruction, and meningeal invasion.
  
  
  CONCLUSIONS
  The association of squamous cell carcinoma and actinic keratosis supports the concept of a causal relation. Excision with histologic examination of actinic keratosis seems to be useful for accurate diagnosis. Squamous cell carcinoma can represent an aggressive tumor with infiltrative growth pattern and should not be considered a benign lesion.
authors.affiliation: Department of Dermatology, CHU-Purpan, Toulouse, France.
authors.forename: H P
authors.initials: HP
authors.lastname: Schwarze
authors.forename: F
authors.initials: F
authors.lastname: Loche
authors.forename: M C
authors.initials: MC
authors.lastname: Gorguet
authors.forename: J
authors.initials: J
authors.lastname: Kuchta
authors.forename: J
authors.initials: J
authors.lastname: Bazex
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery; D003131:Combined Modality Therapy; D018450:Disease Progression; D006801:Humans; D008297:Male; D008578:Meninges / Q000473:pathology*; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D009381:Neoplasms, Radiation-Induced / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery; D009915:Orbit / Q000473:pathology*; D018714:Radiotherapy, Adjuvant; D012867:Skin / Q000473:pathology; D012878:Skin Neoplasms / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery; D013472:Sunlight / Q000009:adverse effects