title: Acantholytic squamous cell carcinoma: is it really a more-aggressive tumor?
abstract: BACKGROUND
  Acantholytic squamous cell carcinoma (ASCC) is frequently considered to be a more-aggressive variant with worse prognosis than other squamous cell carcinoma (SCC) subtypes.
  
  
  OBJECTIVE
  To analyze the biologic behavior of ASCC.
  
  
  METHODS
  We conducted a literature search of articles in English plus a manual search of cited references and common dermatology textbooks.
  
  
  RESULTS
  We found no comprehensive study on the biologic behavior of ASCC. Published data are scant, anecdotal, and contradictory. Of the articles investigated, the recurrence and metastasis rates ranged from 6% to 10% and 2% to 43%, respectively.
  
  
  CONCLUSIONS
  Analysis of the published evidence does not support the assumption that ASCC is a more-aggressive tumor with higher potential for recurrence or metastasis. As with other SCC types, prognosis is more dependent on the characteristics of the host and the location, size, depth, differentiation, and previous treatment of tumors. The treatment and follow-up of patients with ASCC should be similar to those for other types of SCC. The authors have indicated no significant interest with commercial supporters.
authors.affiliation: Department of Dermatology, Oklahoma University Health Sciences Center, Oklahoma City, Oklahoma 73104, USA. carlos-garcia@ouhsc.edu
authors.forename: Carlos
authors.initials: C
authors.lastname: Garcia
authors.forename: A Neil
authors.initials: AN
authors.lastname: Crowson
mesh_terms: D000051:Acantholysis / Q000473:pathology*; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000556:secondary; D006801:Humans; D009364:Neoplasm Recurrence, Local; D012878:Skin Neoplasms / Q000473:pathology*