Adenosquamous carcinoma of the skin: a case series.
BACKGROUND
Adenosquamous carcinoma is an uncommon cutaneous malignant neoplasm with mixed glandular and squamous differentiation and a propensity for aggressive clinical behavior.


METHODS
Of 27 patients diagnosed as having adenosquamous carcinoma, 19 were men and 5 were immunosuppressed. The mean age was 74 years. The majority of tumors were located on the face and scalp (19 of 27 [70%]) or upper extremity (4 of 27 [15%]). Squamous and glandular differentiation was characteristic. Thickness of the primary lesion ranged from 1.2 to 9.2 mm, with all tumors extensively invading the reticular dermis. Perineural invasion was seen in 4 of 27 primary cases (15%). Although 3 of 6 patients treated with Mohs micrographic surgery had subsequent locoregional recurrences, there was no evidence of distant metastasis after a mean of 2.3 years of patient follow-up.


CONCLUSIONS
Adenosquamous carcinoma is best considered as a locally aggressive high-risk subtype of cutaneous squamous cell carcinoma. Tumor thickness and perineural invasion are high-risk histopathological attributes, and immunosuppression is an important clinical risk factor. Although Mohs micrographic surgery may be the best initial treatment, locoregional recurrence is common.
Departments of Dermatology, University of California, San Francisco, USA.
Jennifer M
JM
Fu
Tim
T
McCalmont
Siegrid S
SS
Yu
D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle; D018196:Carcinoma, Adenosquamous / Q000453:epidemiology* / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery; D015331:Cohort Studies; D003131:Combined Modality Therapy; D005148:Facial Dermatoses / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D015994:Incidence; D007868:Leg Dermatoses / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015580:Mohs Surgery / Q000379:methods; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology / Q000473:pathology* / Q000628:therapy; D009367:Neoplasm Staging; D018714:Radiotherapy, Adjuvant; D012042:Registries; D018570:Risk Assessment; D012536:Scalp Dermatoses / Q000473:pathology; D017678:Sex Distribution; D012878:Skin Neoplasms / Q000453:epidemiology* / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery; D016896:Treatment Outcome