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Oral acantholytic squamous cell carcinoma shares clinical and histological features with angiosarcoma

Oliver Driemel1, Urs DA Müller-Richter2*, Samer G Hakim3, Richard Bauer1, Alexander Berndt4, Johannes Kleinheinz5, Torsten E Reichert1 and Hartwig Kosmehl6

Author Affiliations

1 Department of Oral and Maxillofacial Surgery, University of Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany

2 Department of Oral and Maxillofacial Plastic Surgery, University of Würzburg, Pleicherwall 2, 97070, Würzburg, Germany

3 Department of Maxillofacial Surgery, University Medical Center Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany

4 Department of Pathology, University of Jena, Ziegelmühlenweg 1, 07740, Jena, Germany

5 Department of Maxillofacial Surgery, University of Münster, Waldeyerstraße 30, 48149, Münster, Germany

6 Institute of Pathology, HELIOS Hospital Erfurt, Nordhäuser Strasse 74, 99089, Erfurt, Germany

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Head & Face Medicine 2008, 4:17  doi:10.1186/1746-160X-4-17

Published: 31 July 2008



acantholytic squamous cell carcinomas (ASCC) and intraoral angiosarcoma share similar histopathological features. Aim of this study was to find marker for a clear distinction.


Four oral acantholytic squamous cell carcinomas and one intraoral angiosarcoma are used to compare the eruptive intraoral growth-pattern, age-peak, unfavourable prognosis and slit-like intratumorous spaces in common histological staining as identical clinical and histopathological features. Immunohistochemical staining for pancytokeratin, cytokeratin, collagen type IV, γ2-chain of laminin-5, endothelial differentiation marker CD31 and CD34, F VIII-associated antigen, Ki 67-antigen, β-catenin, E-cadherin, α-smooth-muscle-actin and Fli-1 were done.


Cytokeratin-immunoreactive cells can be identified in both lesions. The large vascularization of ASCC complicates the interpretation of vascular differential markers being characteristic for angiosarcoma. Loss of cell-cell-adhesion, monitored by loss of E-cadherin and β-catenin membrane-staining, are indetified as reasons for massive expression of invasion-factor ln-5 in ASCC and considered responsible for unfavourable prognosis of ASCC. Expression of Fli-1 in angiosarcoma and cellular immunoreaction for ln-5 in ASCC are worked out as distinguishing features of both entities.


Fli-1 in angiosarcoma and ln-5 in ASCC are distinguishing features.