A rare case of acral cutaneous squamous cell carcinoma with multiple late cutaneous metastases and extensive neurotropic spread  Erin Lowe, BA, Timothy.

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A rare case of acral cutaneous squamous cell carcinoma with multiple late cutaneous metastases and extensive neurotropic spread  Erin Lowe, BA, Timothy Brown, MD, William A. Geary, MD, PhD  JAAD Case Reports  Volume 2, Issue 1, Pages 34-36 (January 2016) DOI: 10.1016/j.jdcr.2015.11.004 Copyright © 2015 American Academy of Dermatology, Inc. Terms and Conditions

Fig 1 A and B, The original excision (April 2012) yielded a predominantly well-differentiated cSCC with abundant keratin and an associated marked giant cell reaction. Minimal foci of moderate differentiation were present. Tumor closely abutted small cutaneous nerves multifocally. Retrospective S100 protein immunostain confirmed absence of perineural invasion at this time. JAAD Case Reports 2016 2, 34-36DOI: (10.1016/j.jdcr.2015.11.004) Copyright © 2015 American Academy of Dermatology, Inc. Terms and Conditions

Fig 2 The subsequent recurrences (March 2015) were histologically similar. A, Obliterated nerve. B, The cutaneous components include the identical abundant keratin and the associated giant cell reaction. JAAD Case Reports 2016 2, 34-36DOI: (10.1016/j.jdcr.2015.11.004) Copyright © 2015 American Academy of Dermatology, Inc. Terms and Conditions