Basosquamous Carcinoma Research Articles

Basosquamous carcinoma: epigenetic considerations in a case.

Basosquamous carcinoma: epigenetic considerations in a case.

Demographic analysis of non-melanoma skin cancers in the southeastern anatolia

Aim: To make a demographic analysis of patients operated on because of skin cancer in the last ten years in the Diyarbakir region of Turkey. Information was mapped related to age, gender, localization, grade, and size of skin cancers other than melanoma.Material and Methods: A retrospective examination was made of patient data in the computerized information system from the last ten years. Age and gender of the relevant patients, tumour diagnosis, size, and localization were recorded. Results: From the archive scan, the data of 733 patients were retrieved. The diagnosis was basal cell carcinoma (BCC) in 540 cases, squamous cell carcinoma (SCC) in 154, and basosquamous cell carcinoma (BSCC) in 32. BCC was determined more in males (M/F:280/260), localization was mostly in the nasal region and it was seen most in the 60-70 years age range. SCC was diagnosed more in males (M/F:92/62) in the 70-80 years age group, and the most common localization was on the cheek. BSCC was observed more often in females (M/F:14/18). Conclusion: Diyarbakir is geographically located in the South-east Anatolian region of Turkey, those who live there are exposed to long hours of intense sunlight in certain months of the year. In this region, BCC and SCC were seen more in males and BSCC was determined more in females. When it is considered that UV exposure is significant in the etiology of skin cancers, it can be concluded that characteristics change according to geographic region and epidemiological characteristics (skin type, genetic factors, regional working conditions).

Reconstruction of Complex Scalp Defects in Different Locations: Suggestions for Puzzle.

Objective:Scalp defects may occur following trauma, radiotherapy, oncologic resection, and recurrent surgeries. The hair-bearing scalp has a dual role, which consists of protecting the calvarium and contributing to aesthetic appearance. While the “reconstructive ladder” approach may be used to close small and medium-sized scalp defects, it is not the case for larger ones involving the calvarium or with a radiation therapy history. The aim of this study is to present cases operated due to complex scalp defects, analyze complications, and discuss the choice of reconstruction.Material and Methods:The study consists of 14 patients who were operated between December 2017 and August 2019 due to a complex scalp defect. Patient were evaluated according to age, gender, etiology, radiation therapy history, defect size and location, reconstruction steps, cranioplasty and duraplasty options, type of free flap, recipient artery, vein graft requirement, and complications.Results:The mean age of patients, which consists of 11 men and three women, was 56.7 years. The etiology for scalp defects included basosquamous carcinoma, squamous cell carcinoma, giant basal cell carcinoma, atypical meningioma, glioblastoma multiforme, angiosarcoma, and anaplastic oligodendroglioma. The defect involved the full thickness of calvarium in nine cases and pericranium in five cases. Cranioplasties were made with rib graft (n=1), bone graft (n=1), and titanium mesh (n=7). Free flaps used for reconstruction were musculocutaneous latissimus dorsi (LD) (n=4), LD muscle (n=3), anterolateral thigh (ALT) (n=4), musculocutaneous ALT (n=1), vastus lateralis muscle (1), and rectus abdominis muscle (n=1). Flap loss was not observed. Complications occurred in four of the patients; include a partial graft loss, a wound dehiscence, seroma, and an unsatisfactory esthetic result.Conclusion:Free tissue transfers rather than local flaps should be opted to reconstruct complex scalp defects, as failure of the latter, could create much greater defects, and worse consequences. There are many options for proper reconstruction, and it is essential to select the appropriate one, taking into account the comorbid conditions of each case.

Slow Mohs surgery for the treatment of periocular basal cell carcinomas, three and five year follow‐up

AbstractPurposeBasal cell carcinoma (BCC) is the most common skin malignancy, disproportionately occurring in sun exposed areas, such as the eyelids. Whilst surgical excision is considered the most effective method for treating periocular BCCs, there is a paucity of evidence as to which surgical technique is the most appropriate. Mohs micrographic surgery is likely superior to traditional surgical excision in achieving clear excision margins and sparing tissues, but requires immediate access to histology. Slow Mohs surgery offers an alternative when immediate histology is unavailable, as tumour excision and reconstruction are performed in two separate procedures. In this retrospective case series is reported the 3 and 5 year outcomes following Slow Mohs surgery.Methods193 consecutive patients who had undergone Slow Mohs surgery, between January 2009 and December 2015 at a large district general hospital were identified retrospectively using electronic theatre records. Electronic lab reports and patient records were then utilised and the data analysed using EXCEL and SPSS.Results160 patients had a diagnosis of BCC or basosquamous carcinoma. Following exclusions, 141 survived to be included in the 3 year recurrence cohort. Of these, 2.83% had recurred at 3 years. A smaller group of 72 patients survived and had follow‐up lasting 5 years, within this group there was a recurrence rate of 4.16%.ConclusionSlow Mohs potentially achieves recurrence rates comparable to Mohs micrographic surgery, offering an alternative should immediate histological examination not be available. There currently exists little evidence comparing the techniques prospectively, nor is there cost comparison between them.

The Prognostic Value of Podoplanin Expression in Nonmelanoma Skin Cancers: Correlation With Lymphatic Vessel Density

Podoplanin is one of the integral molecules controlling cellular motility and migration that is considered crucial in initiating tumor invasiveness and metastasis. This work aimed at studying the immunohistochemical expression of podoplanin in nonmelanoma skin cancers (NMSCs) and seborrheic keratosis (SK) in comparison to normal control skin and to evaluate its possible role in their pathogenesis. This study included 120 patients and paraffin blocks of epidermal tumors [30 SK, 30 basal cell carcinoma (BCC), 30 basosquamous carcinoma (BSC) and 30 squamous cell carcinoma (SCC)], in addition to 30 normal control skin specimens from age- and sex-matched healthy volunteers. All were examined for intratumoral and peritumoral immunohistochemical expression of podoplanin antibody (D2-40). In addition, morphometric measurement of lymphatic vessel density was evaluated in all studied specimens. Podoplanin expression was significantly upregulated in all the studied epidermal tumor specimens in comparison to normal control skin specimens. The highest mean value of podoplanin expression (both intratumoral and peritumoral cells) was observed in SCC followed by BSC, then BCC, SK, and control skin in the same sequence. Positive correlations were detected between its expression in both BSC and SCC with the mean of lymphatic vessel density in the studied specimens and the presence of lymph node metastasis. Podoplanin plays an evident role in the development and progression of both benign and malignant skin neoplasms and may serve as a potential predictor of their clinical course and prognosis.

Defining the Genetics of Basosquamous Carcinoma

Basosquamous carcinoma (BSC) is a rare form of skin cancer with both basaloid and squamous morphology. Chiang etal. (2019) genetically define BSCs and demonstrate that BSCs likely originate as basal cell carcinomas that partially squamatize through accumulation of ARID1A mutations and RAS/MAPK pathway activation.

471 Genetic mutations underlying phenotypic plasticity in basosquamous carcinoma

471 Genetic mutations underlying phenotypic plasticity in basosquamous carcinoma

Utility of Ber-EP4 and MOC-31 in Basaloid Skin Tumor Detection.

Ber-EP4 has been the traditional immunostain used for the detection of basaloid skin tumors. Recently, MOC-31 has shown be superior to Ber-EP4 in the detection of basosquamous basal cell carcinoma (BCC) and many centers are now using both Ber-EP4 and MOC-31 antibodies together to detect these lesions. The objective of this study was to compare the utility of using both Ber-EP4 and MOC-31 immunostains in the detection of basaloid skin tumors and to better characterize the previously unknown staining properties of MOC-31 in cutaneous lesions. To do this, 76 basaloid skin tumors stained with both Ber-EP4 and MOC-31 were obtained. Diagnoses included basosquamous BCC, Merkel cell carcinoma, adenoid cystic carcinoma, microcystic adnexal carcinoma, sebaceous carcinoma, trichoepithelioma, trichoblastoma, sebaceous adenoma, sebaceoma, and follicular induction overlying dermatofibroma. The distribution and intensity of Ber-EP4 and MOC-31 staining in these lesions was scored. These scores were analyzed using a truth table, χ test, and Pearson correlation tests. The overall mean and SD of the scores were also obtained. Overall, we found Ber-EP4 and MOC-31 to be statistically equivalent immunostains for the diagnosis of basaloid skin tumors. We recommend the use of only one of these antibodies and favor MOC-31 for the detection of basaloid skin tumors. We also describe MOC-31 staining properties in different cutaneous lesions.

Treatment of inoperable basosquamous carcinoma with hedgehog inhibitors, vismodegib and sonedigib: A case series

Treatment of inoperable basosquamous carcinoma with hedgehog inhibitors, vismodegib and sonedigib: A case series

Genetic Mutations Underlying Phenotypic Plasticity in Basosquamous Carcinoma

Basosquamous carcinoma (BSC) is an aggressive skin neoplasm with the features of both basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). While genetic drivers of BCC and SCC development have been extensively characterized, BSC has not been well studied, and it remains unclear whether these tumors originally derive from BCC or SCC. In addition, it is unknown which molecular pathways mediate the reprogramming of tumor keratinocytes toward basaloid or squamatized phenotypes. We sought to characterize the genomic alterations underlying sporadic BSC to elucidate the derivation of these mixed tumors. We identifed frequent Hedgehog (Hh) pathway mutations in BSCs, implicating Hh deregulation as the primary driving event in BSC. Principal component analysis of BCC and SCC driver genes further demonstrate the genetic similarity between BCC and BSC. In addition, 45% of the BSCs harbor recurrent mutations in the SWI/SNF complex gene, ARID1A, and evolutionary analysis revealed that ARID1A mutations occur after PTCH1 but before SCC driver mutations, indicating that ARID1A mutations may bestow plasticity enabling squamatization. Finally, we demonstrate mitogen-activated protein kinase pathway activation and the loss of Hh signaling associated with the squamatization of BSCs. Overall, these results support the genetic derivation of BSCs from BCCs and highlight potential factors involved in modulating tumor reprogramming between basaloid and squamatized phenotypes.

Silymarin-loaded nanostructured lipid carrier gel for the treatment of skin cancer.

Aim: The present study was aimed at determining the antiproliferative, antioxidant, anti-inflammatory and antitumor activity of developed silymarin-nanostructured lipid carrier (NLC) gel. Materials & methods: B16 melanoma cell line and albino mice were used as ex vivo and in vivo models, respectively, to evaluate the aforementioned pharmacological activities. Results: The volume of large tumors significantly (p<0.05) reduced from 5.02 to 3.05mm3, levels of IL-1α and TNF-α were significantly (p<0.001) lower and levels of superoxide dismutase (SOD), catalase (CAT) and glutathione (GSH) significantly (p<0.0001) increased in the group treated with silymarin-NLC gel. Furthermore, in skin treated with placebo and conventional gels, a basosquamous carcinoma and squamous cell carcinoma were noticed, respectively. Conclusion: Silymarin-NLC gel presented better treatment outcomes compared with silymarin-conventional gel.

Basosquamous Carcinoma of Skin in A Developing Community

Recently, single case reports were published from India, Romania, UK, and USA. Its rarity was stressed as well as the histological combination of both basal cell carcinoma and squamous cell carcinoma. The ages ranged from 71 to 86 years and most were females. Therefore, this paper reports the experience from a developing community in Nigeria with special reference to members of the Ibo ethnic group in whom the site of preponderance was the head and the sex was the female.

Degree of differentiation of cutaneous squamous cell carcinoma: a comparison between a Swedish cohort of organ transplant recipients and immunocompetent patients.

BackgroundOrgan transplant recipients (OTRs) have a very high risk of developing cutaneous squamous cell carcinoma (cSCC). Immunosuppressed OTRs may have a higher proportion of poorly differentiated cSCC than non-OTRs.ObjectivesThe aim of this study was to investigate the degree of differentiation of cSCCs in OTRs compared with immunocompetent individuals.Patients/MethodsData from the Swedish Cancer Registry were crosschecked with data from the Transplant registry of the Transplant Institute at Sahlgrenska University Hospital in Gothenburg, Sweden. All OTRs with a diagnosis of cSCC, basosquamous carcinoma, and/or cSCC in situ established at the Department of Dermatology, Sahlgrenska University Hospital, during 2002–2015 were included. The control group consisted of non-OTRs with the same diagnoses during the same time period.ResultsDuring 2002–2015, 82 OTRs diagnosed with 515 tumors and 883 non-OTRs with 1,247 tumors were included. OTRs developed 0.47 tumors/year vs 0.10 tumors/year for non-OTRs, but no significant differences were observed in the degree of tumor differentiation of invasive cSCCs between OTRs and non-OTRs (P = 0.4). The distribution of poorly, moderately, and well-differentiated invasive cSCCs among OTRs and non-OTRs were 8.5% vs 12.5%, 22.1% vs 29.9%, and 69.4% vs 57.6%, respectively.ConclusionsOTRs do not develop a higher proportion of poorly differentiated cSCCs than non-OTRs.

Surgical Excision with Rotational Flap Reconstruction for Basosquamous Cell Carcinoma in Xeroderma Pigmentosa: A Case Report.

Xeroderma pigmentosa (XP) is a rare autosomal recessive disorder which is characterized by a defect in nucleotide excision repair of DNA following exposure to UV radiation. This leads to hypersensitivity to sunlight causing pigmented skin lesions, photophobia and a 1000-fold increase in risk of developing cutaneous malignancies like basal cell carcinomas, squamous cell carcinomas and melanomas of head and neck. We present an interesting case of a 28year old man with basosquamous cell carcinoma secondary to XP treated successfully with surgical excision and reconstruction with rotational flap technique.

Basosquamous Carcinoma: Report of Two Cases and Review of Literature

Basosquamous Carcinoma: Report of Two Cases and Review of Literature

A custom positioning aid for an auricular prosthesis: A clinical report

This report describes the treatment of a 68-year-old man with basosquamous cell carcinoma of the left auricular area. His oncologic treatment resulted in the loss of his left ear and much of the left temporal bone. The loss of a significant portion of the temporal bone precluded the use of extraoral implants. Owing to the lack of anatomic landmarks after his surgical treatment, positioning his auricular prosthesis proved challenging. The fabrication of his prosthesis and a custom positioning aid are described.

Basosquamous Carcinoma: A Single Centre Clinicopathological Evaluation and Proposal of an Evidence-Based Protocol

Basosquamous carcinoma (BSC) is an uncommon skin malignancy with significant invasive and metastatic potential. There are currently no clear management guidelines. This study evaluates the management and outcomes of patients diagnosed with BSC over a 7-year period. We present an evidence-based unit protocol for the management of BSC. All patients treated for BSC between 2009 and 2015 were reviewed. Data collected included patient demographics, tumour-specific information, management strategy, presence of recurrence or metastasis, and details of follow-up. 74 patients were identified, making this one of the largest cohorts of BSC patients reported. Mean age at diagnosis was 75.4 years, with a male:female ratio of 1.6:1. The most common tumour site was the head and neck (n=43, 58.1%). All tumours were graded at pT1 (n=51) or pT2 (n=23). Inadequate excision occurred in 17 patients (23%). Mean excision margins were >4mm peripherally and deep. Inadequately excised BSCs were further treated with wide local excision (n=6) or radiotherapy (n=5), or both (n=1). There were no cases of local recurrence or metastatic disease. This study demonstrates a cohort of patients with BSCs that appear less aggressive than previously reported. Current management with surgical excision appears to produce adequate results. However, an evidence-based guideline is still lacking.

Sentinel lymph node metastasis in primary cutaneous basosquamous carcinoma. A cross-sectional study.

Basosquamous carcinoma (BSC) is a rare, biologically aggressive tumor. This cross-sectional study aims to define risk factors for subclinical nodal metastasis in primary BSC, and identify the patients who would benefit from routine sentinel node biopsy (SLNB) as part of the initial management. A total of 142 patients, with histologically proven BSC without palpable lymph nodes, underwent SLNB after the initial excision. Clinicopathological features and demographics were analyzed between the patients with detected micrometastasis (SLNM) and those with negative SLN. In 7.7% patients, subcapsular and <0.1 mm SLNM were found. The frequency of SLNM was 0.9%, 11.8%, and 80.0% in patients with maximum lesion diameter ≤ 2 cm, 2.1-3.0 cm and >3.0 cm, respectively (P < 0.001) and was strongly associated with perineural (P < 0.001; OR = 26.46, 95% CI = 5.62-124.52) and lymphatic invasion (P < 0.001; OR = 17.35, 95% CI = 4.44-67.91). Within 18-84 months, no recurrence or metastasis were observed in SLNM positive patients. False negative SLNB rate of 15.4% was recorded. Cutaneous BSC is associated with early nodal metastatic potential. Tumor size >2 cm, lymphatic and perineural invasion are significant determinants for SLN micrometastasis. In the absence of palpable lymphadenopathy, wide resection and SLNB with long-term follow-up are highly recommended in these patients.

Pattern of skin cancer in north western region of Yemen

The pattern of skin cancer differs in different countries. The aim of this study is to identify the pattern of skin cancer in northwestern region in Yemen and to compare it to similar studies done in southern Yemeni governorates and in neighborhood. This is a descriptive prospective study of patients data with histologically diagnosed skin cancers carried out in the Saudi hospital in Sa'adah and Hajjah governorates in Yemen between Jan.2007 and Dec.2014. The data were collected and recorded on proforma and was analyzed according to the type of tumor, age and gender of the patients and anatomical site involved. Two histopathologists investigated the specimens. There were 324 Yemeni patients with skin malignancy, 204 were males (63%) and 120 were females (37%), the M: F ratio was 1.7:1. Most of the patients were over the age of 60 years and the mean age of all cases was 66.4 years. Squamous cell carcinoma was the most frequent (50%), followed by basal cell carcinoma (29%), Non-Hodgkin's lymphoma (4.9%), malignant melanoma (4%), and Kaposi's sarcoma (3.7%). Other rare primary skin cancers such as basosquamous carcinoma, adnexal carcinoma, dermatofibrosarcoma protuberans, neuroendocrine carcinoma, extramammary Paget's disease and aggressive angiomyxoma were recorded. Metastatic skin lesions were seen in six patients. The patterns of skin cancer in northwestern governorates of Yemen are nearly similar to international studies with higher incidence of squamous cell carcinoma. Head and neck was the most common affected site, followed by lower extremities. Community education about the risk of long exposure to sunlight is important, including coverage of the head and neck when working outdoor under sunny weather.

Basosquamous Carcinoma Of Nose: A Rare Tumor Diagnosed On Cytology

Basosquamous carcinoma (BSC) is a rare subtype of basal cell carcinoma (BCC) with an incidence of 1-2%. BSC is characterized by aggressive nature in terms of poor prognosis and distant metastasis. Unlike BCC which is a rodent ulcer with local invasion and no distant metastasis. BSC is usually diagnosed on histopathology examination after biopsy. We hereby present a case report of diagnosis of BSC on cytological examination followed by confirmation with histopathology. To the best of our knowledge, there is the first case reported in literature on this matter. We emphasize the importance of thorough cytological examination so as to suspect and finally confirm this rare entity.DOI: 10.21276/APALM.1679