Adenosquamous Carcinoma of the Skin: A Case Series | Dermatology | JAMA Dermatology | JAMA Network
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October 2009

Adenosquamous Carcinoma of the Skin: A Case Series

Author Affiliations

Author Affiliations: Departments of Dermatology (Drs Fu, McCalmont, and Yu) and Pathology (Dr McCalmont), University of California, San Francisco. Dr Fu is now in private practice in El Cerrito, California.

Arch Dermatol. 2009;145(10):1152-1158. doi:10.1001/archdermatol.2009.218

Background  Adenosquamous carcinoma is an uncommon cutaneous malignant neoplasm with mixed glandular and squamous differentiation and a propensity for aggressive clinical behavior.

Observations  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.