Acantholytic Squamous Cell Carcinoma

Acantholytic SCCs tend to be more dangerous than regular well-differentiated SCCs, and it is because of their intrinsic nature.  The cells, which in a normal SCC are connected to one another by intracellular bridges (desmosomes) are loosely connected, if at all.  The resultant SCC is spongier, usually more erythematous and has more os an eroded surface.  Because of this, they deserve more respect than a well differentiated SCC.  We have code words for prioritizing SCCs and melanomas for excision, and melanomas and Acantholytic SCCs get the same code word: ASAP!

These cancers tend to metastasize more frequently, and as most of you noted, they go to the lymph nodes (in this case, the parotid nodes and anterior cervical nodes) and then to the lungs, because that is the most common place for them to be caught in a fine capillary network.