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A Case of Metastatic Squamous Cell Carcinoma Arising from Actinic Cheilitis

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초록

Actinic keratosis (AK) is a common, sun-induced, premalignant lesion with a strong likelihood of progressing to a malignancy. The reported risk of AK progressing to squamous cell carcinoma (SCC) varies from less than 1% to 20%. Clinically, induration, pain, large size, marked hyperkeratosis, ulceration, bleeding, rapid growth, and recurrence or persistence may be markers of AK progression into SCC. The risk of SCC metastasizing ranges between 0.5% and 3%. However, SCC of the lip arising from actinic cheilitis is more prone to metastasis than cutaneous SCC,with rates of the former varying between 3% and 20%. Here we report a typical case of SCC from actinic cheilitis with metastasis to the lymph nodes during a 4-year follow-up period. To exclude SCC, we emphasize the need for regular follow-up and prompt evaluation, including careful pathologic examination for actinic cheilitis. (Ann Dermatol 23(1)101∼103, 2011)

Abstract

Actinic keratosis (AK) is a common, sun-induced, premalignant lesion with a strong likelihood of progressing to a malignancy. The reported risk of AK progressing to squamous cell carcinoma (SCC) varies from less than 1% to 20%. Clinically, induration, pain, large size, marked hyperkeratosis, ulceration, bleeding, rapid growth, and recurrence or persistence may be markers of AK progression into SCC. The risk of SCC metastasizing ranges between 0.5% and 3%. However, SCC of the lip arising from actinic cheilitis is more prone to metastasis than cutaneous SCC,with rates of the former varying between 3% and 20%. Here we report a typical case of SCC from actinic cheilitis with metastasis to the lymph nodes during a 4-year follow-up period. To exclude SCC, we emphasize the need for regular follow-up and prompt evaluation, including careful pathologic examination for actinic cheilitis. (Ann Dermatol 23(1)101∼103, 2011)

참고문헌 (9)

  1. Ducan KO, "Epithelial precancerous lesions. In Fitzpatrick’s dermatology in general medicine. 7th ed", pp.1007~1027 (2008), New York: Mc Graw Hill
  2. Markopoulos A, "Actinic cheilitis: clinical and pathologic characteristics in 65 cases", Oral Dis, 10, pp.212~216 (2004)
  3. Cavalcante AS, "Actinic cheilitis: clinical and histological features", J Oral Maxillofac Surg, 66, pp.498~503 (2008)
  4. Marks R, "Malignant transformation of solar keratoses to squamous cell carcinoma", Lancet, 1, pp.795~797 (1988)
  5. Abreu MA, "Actinic cheilitis adjacent to squamous carcinoma of the lips as an indicator of prognosis", Braz J Otorhinolaryngol, 72, pp.767~771 (2006)
  6. Glogau RG, "The risk of progression to invasive disease", J Am Acad Dermatol, 42, pp.23~24 (2000)
  7. Picascia DD, "Actinic cheilitis: a review of the etiology, differential diagnosis, and treatment", J Am Acad Dermatol, 17, pp.255~264 (1987)
  8. Moy RL, "Clinical presentation of actinic keratoses and squamous cell carcinoma", J Am Acad Dermatol, 42, pp.8~10 (2000)
  9. Robinson JK, "Actinic cheilitis. A prospective study comparing four treatment methods", Arch Otolaryngol Head Neck Surg, 115, pp.848~852 (1989)

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