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.
Fu
Jennifer M
JM
Departments of Dermatology, University of California, San Francisco, USA.
McCalmont
Tim
T
Yu
Siegrid S
SS
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