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A Highly Malignant Neoplasm Composed of Acantholytic Round Keratinocytes

Shuichi Ikegawa, MD; Toshiaki Saida, MD; Yoshihiro Takizawa, MD; Yasutaka Tokuda, MD; Takashi Ito, MD; Fumio Fujioka, MD; Tetsuhiko Sakaki, MD; Naoyuki Uchida, MD; Seiji Arase, MD; Katsuyuki Takeda, MD

Arch Dermatol. 1989;125(12):1672-1676.

Abstract
• Two patients had unusual squamous cell carcinoma (SCC) arising in a burn scar. The SCCs rapidly recurred and metastasized after radical operation, and the patients died of disseminated metastases. Histopathologically, the SCC was poorly differentiated and consisted of acantholytic round cells that diffusely proliferated into the deep dermis. However, small, solid nests composed of squamoid cells were focally observed. Immunohistochemical studies revealed that the acantholytic round neoplastic cells expressed not only keratin but also vimentin, and the coexpression was substantiated with double immunostaining. Vimentin-positive SCC composed of acantholytic round neoplastic cells may be a highly malignant subset of cutaneous SCC.

(Arch Dermatol. 1989;125:1672-1676)

Author Affiliations
From the Departments of Dermatology (Drs Ikegawa, Saida, Takizawa, Tokuda, and Ito) and Orthopedic Surgery (Dr Fujioka), Shinshu University School of Medicine, Matsumoto, Japan; and the Department of Dermatology, Tokushima (Japan) University School of Medicine (Drs Sakaki, Uchida, Arase, and Takeda).

Footnotes
Accepted for publication June 20, 1989.

Reprint requests to the Department of Dermatology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto 390, Japan (Dr Ikegawa).

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