Since the extensive publications of Bowen,1 Darier,2 Jessner,3 Arzt,4 Arzt and Biach5 and Ducrey,6 a great number of cases of Bowen's disease have been published. It should be stated that usually Bowen's disease is harmless and benign, in spite of the general supposition that it is a definite precancerosis, that is, a disease in the course of which a formation of genuine tumors and metastases takes place "without exception and with certainty" (Beck7). The relative benignity has led Arzt and Biach5 to express the belief that real Bowen's disease does not form metastases. There are, however, rare cases in which genuine metastases in the regional glands and in the internal organs occur. If one follows Darier's opinion that the typical histologic picture has to be found in the metastases, there remain only few cases belonging to the group in which malignancy
KUZNITZKY E, JACOBY H. BOWEN'S DISEASE WITH METASTASES(EPITHELIOMA OF BOWEN). Arch Derm Syphilol. 1938;38(2):191–197. doi:10.1001/archderm.1938.01480140031002
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