Introduction: Acantholytic squamous cell (adenosquamous) carcinoma of the skin are relatively rare subtype of squamous cell carcinoma, usually found in elderly on sun-exposed areas of the skin, predominately head, neck and upper extremities. Incidence of metastasis is 2-14%.
Case Outline: A case of a 76-year-old male, with the signs of left-sided facial palsy and cervical mass on the same side, is presented. Five months prior to the visit, due to acantholytic squamous cell carcinoma, an excision of the ulceration of the superior third of the left auricle was performed. Patient underwent surgical treatment, after pathohistological and radiological confirmation of the infiltrative neck metastasis. Postoperatively, rapid locoregional progression of the disease was noted in the patient, with a lethal outcome.
Conclusion: Squamous cell carcinoma (including acantholytic subtype) with lesions bigger than 4 cm in size in auricular-temporal region, signs of deep tissue invasion, and lymphovascular and perineural invasion have higher local metastatic potential. More frequent oncological check-ups with radiological examination are necessary in detecting locoregional metastasis.
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