RESOLUCIÓN DE DIAGNÓSTICO HISTOLÓGICO DIFÍCIL DEL CARCINOMA ESCAMOSO ACANTOLÍTICO RARO MEDIANTE INMUNOHISTOQUÍMICA:...

Acantholytic squamous cell carcinoma (ASCC), also known as adenoid squamous cell carcinoma, typically affects elderly men in the skin of the head and neck region especially due to exposure to sunlight. It rarely occurs in the oral mucosa but when it does, it is characterized by aggressive biological behaviour and the ability for distant metastasis with very poor prognosis.

We report the case of a 73-year-old man diagnosed with ASCC of the left maxillary region who died three (3) months following presentation.

Histopathology revealed component cells made up the nests, which were mostly basaloid and slightly pleomorphic with discohesiveness of the epithelial cells at the center of the nest. This histology appearance mimics vascular neoplasms like angiosarcoma with a cellular event like vascular invasion. An immunohistochemistry for AE1/AE3 and CD 34 was employed to resolve the diagnostic challenge encountered within the histology evaluation and distinguish it from other similar entities.

This case report highlights the need for immunohistochemical study of the unique and rare oral ASCC whose definitive diagnosis may be missed because of similarities with other entities.