Schwartz R A
J Surg Oncol. 1979 Dec;12(4):305-17. doi: 10.1002/jso.2930120404.
The keratoacanthoma (KA) is a relatively common tumor which most often occurs on the sun-exposed areas of light skinned individuals of middle age and older. It may be viewed as an aborted squamous cell carcinoma that only in rare instances evolves into a progressively growing squamous cell carcinoma. As such, the recognition of the true nature and the proper management of this tumor is of considerable practical importance. The rapid evolution of a KA may be divided into a proliferative stage, a fully developed tumor, and an involuting stage. Within weeks it develops from a rapidly growing, firm, smooth nodule into a mature bud or dome-shaped tumor with a central keratotic core that finally degenerates into an involuting keratinous mass. Although the KA usually appears as a solitary lesion, multiple tumors may be found, as may a number of morphologic and syndromic variants, including the appearance of the KA in the Torre syndrome. The KA is likely to be derived from cells of the hair follicle. Its etiology is unclear, although ultraviolet light, viruses, oncogenic chemicals, and epidermal growth factor have been considered. The histologic features of the KA are often very similar to those of a cutaneous squamous cell carcinoma; however, the tumor architecture usually provides a basis for their distinction.
角化棘皮瘤（KA）是一种相对常见的肿瘤，最常发生于中老年浅色皮肤个体的阳光暴露部位。它可被视为一种未发育完全的鳞状细胞癌，仅在极少数情况下会演变成逐渐生长的鳞状细胞癌。因此，认识这种肿瘤的真正性质并进行恰当处理具有相当重要的实际意义。KA的快速演变可分为增殖期、完全成熟的肿瘤期和消退期。在数周内，它从一个快速生长、质地坚硬、表面光滑的结节发展成一个成熟的芽状或圆顶状肿瘤，中央有角质核心，最终退化为一个消退的角质团块。虽然KA通常表现为单个损害，但也可能发现多个肿瘤，以及一些形态学和综合征性变异，包括托里综合征中出现的KA表现。KA可能起源于毛囊细胞。其病因尚不清楚，尽管紫外线、病毒、致癌化学物质和表皮生长因子都曾被考虑过。KA的组织学特征通常与皮肤鳞状细胞癌非常相似；然而，肿瘤结构通常为它们的鉴别提供依据。
