Savage Jacqueline A, Maize John C
Departments of *Pathology and Laboratory Medicine, College of Medicine, and †Dermatology, Medical University of South Carolina, Charleston, SC.
Am J Dermatopathol. 2014 May;36(5):422-9. doi: 10.1097/DAD.0000000000000031.
As of 2013, keratoacanthomas (KAs) have not been decided on as either a benign or a malignant entity. Originally considered benign epidermal growths, the assertion by Hodak, Jones, and Ackerman that these lesions are truly "an expression of squamous cell carcinoma" (SCC) fueled the controversy and placed some of the biggest names in the field on opposite sides of the issue. Without a clear understanding of the etiology of KAs and without stringent diagnostic criteria, the literature in regard to KA contains scant reports of their "metastatic potential." Four hundred forty-five cases of KA with reported follow-up and outcomes were reviewed from 113 published articles. In our data set, none of these cases resulted in death or distant metastases. When compared with 429 cases of SCC of the skin, with 61 cases of metastases and 24 deaths as a direct result of SCC, the biologic behavior of the 2 entities is distinct and evident. KAs are benign epidermal growths and not a malignant variant of SCC.
截至2013年，角化棘皮瘤（KA）究竟是良性还是恶性病变尚无定论。KA最初被认为是良性表皮增生，然而霍达克、琼斯和阿克曼断言这些病变实际上是“鳞状细胞癌（SCC）的一种表现形式”，这引发了争议，使该领域的一些知名人士在这个问题上持相反观点。由于对KA的病因缺乏清晰认识且没有严格的诊断标准，关于KA的文献中很少有其“转移潜能”的报道。我们从113篇已发表文章中回顾了445例有随访和结局报告的KA病例。在我们的数据集中，这些病例均未导致死亡或远处转移。与429例皮肤SCC病例相比，其中61例发生转移，24例直接死于SCC，这两种病变的生物学行为截然不同且显而易见。KA是良性表皮增生，而非SCC的恶性变体。
