Metastatic Bowen carcinoma.

A 72-year-old man presented with basaloid squamous cell carcinoma metastatic to both lungs that was morphologically similar to recurrent, invasive moderately to poorly differentiated carcinoma arising from persistent Bowen's disease of the right cheek. The original lesion of invasive moderately differentiated squamous cell carcinoma arising in Bowen's disease had been excised 11 years previously. Mohs' surgery was performed for the recurrent lesion on the cheek 12 months prior to detection of lung metastases. He died of respiratory failure 19 months following diagnosis of his metastatic disease. Our case reflects the potentially aggressive nature of invasive squamous cell carcinoma arising from Bowen's disease and highlights the importance of approaching this entity with a view to complete surgical excision with adequate margins.