Adenoid Squamous Cell Carcinoma (Adenoacanthoma of Lever)

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Abstract
Adenoacanthoma (Lever)9 is a distinctive tumor of the skin, best designated as ``adenoid squamous cell carcinoma." From a review of the histopathologic material seven cases seen at the Mayo Clinic from the period 1940 through 1962 are presented, and published reports of 15 additional cases are reviewed. The tumors occurred in persons aged 50 or more, usually on the face, and were associated with chronic sun damage to the skin. Three times as many men as women were affected. Basal cell carcinomas and actinic keratoses were associated frequently, and in three instances keratoacanthomas had occurred. Although origin from epidermis was more frequent, close association with hair follicles was noted in five of our cases. No relationship to sweat glands was observed. Clinically the tumor is a small, slow-growing lesion resembling actinic keratosis or—less often—a large, chronic ulcer of many years' duration. Occasionally the morphology and growth rate were similar to those of keratoacanthoma. The tumor is basically a squamous cell carcinoma having distinctive adenoid proliferation with dyskeratosis and acantholytic-like cells. The treatment of choice is local excision, as recurrence is more likely to follow electrodesiccation. Perineural lymphatic extension in one case underscored the malignant potential of this tumor.

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