Abstract

Context: Adenosquamous carcinoma of the skin is a rare but unique disease that usually has an aggressive course. Primary cutaneous Adenosquamous carcinoma is best considered as a locally aggressive high-risk subtype of cutaneous squamous cell carcinoma. A few well-documented and uncontested instances of primary cutaneous Adenosquamous carcinoma have been described to date. However, given its rarity, data about local recurrence and distant metastasis rates are sparse, and guidelines for the optimal method of excision and the role of adjuvant therapy are lacking. We reported a primary Adenosquamous carcinoma of the skin. Design: A 71-year-old female presented with a right cheek lesion evaluation. The patient had no previous medical history. Physical examination revealed a raised, 2 x 1.5 x 0.5 cm, red, nontender, ulcerated plaque with slight exudate and gelatinous texture on the right cheek. The lesion is biopsied. Results: The H&E section demonstrates an atypical neoplasm displaying both squamous and glandular differentiation. There is a proliferation of cytologically atypical P40 positive keratinocytes components that appears to arise from the overlying epidermis. CK5/6 immunohistochemical stain demonstrates strong and diffuse positivity, which also supports a primary cutaneous origin. Multiple glandular structures, some demonstrating mucinous differentiation, are also observed, which stains positive for mucicarmine. Conclusions: Adenosquamous carcinoma is a locally aggressive, high-risk form of cutaneous squamous cell cancer. Tumors with the above-mentioned appearance should be designated as Adenosquamous carcinomas by pathologists. In such cases, the possibility of a metastatic origin must always be ruled out.

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