Adenoid squamous cell carcinoma (adenoacanthoma): A clinicopathologic study of 155 patients

Abstract

The lesions of adenoid squamous cell carcinoma develop in exposed areas, particularly about the head and neck regions in persons with fair skin who spend considerable time outside. The microsocopic features consist of invasion of the corium by proliferating atypical epithelial cells forming an adenoid pattern. The adenoid structure is usually composed of a single peripheral layer of cohesive cuboidal epithelial cells, and toward the center of the lobule there is acantholysis with formation of lumina containing dyskeratotic cells. The precursor stages of adenoid squamous cell carcinoma are classified histopathologically as senile keratosis with acantholysis. The most frequent histologic site of origin in this material was from the upper part of the pilary outer root sheath but some arose from the epidermis. Mucin associated with the adenoid structure showed identical histochemical reactions to those of mucin occurring in the pilary sheath and epidermis (hyaluronic acid) and differed from those of mucin seen in sweat glands (sialomucin). Among 155 patients having 213 lesions of adenoid squamous cell carcinoma there was metastasis in 3 patients (to regional lymph nodes in 2 and to regional lymph nodes and to lung in 1) and direct extension in 2 patients, which led to the death of the 5 patients. Surgical excision is the treatment of choice. Copyright © 1966 American Cancer Society