Case Of Basaloid Squamous Carcinoma Research Articles

Potential prognostic implication of α-smooth muscle actin (Α-SMA) in oral squamous cell carcinoma compared with basaloid squamous carcinoma

<h3>Objectives</h3> Oral squamous cell carcinoma is the most common multistep malignant tumor affecting the oral cavity. One of the most aggressive variants of this neoplasm is the basaloid squamous carcinoma. The cancer-associated fibroblasts in the tumor microenvironment are now the focus of intense research and are believed to correlate with poor prognosis. They are characterized by α-smooth muscle actin (α-SMA) expression, which is a myofibroblast marker. The aims of the present study were as follows: (1) to evaluate the role of α-SMA in the progression of both neoplasms, (2) to study the prevalence of this marker with different grades of this neoplasia, and (3) to determine the immunoreactive localization of α-SMA in the lymph nodes of patients with these tumors. <h3>Methods</h3> Twenty-one cases of squamous cell carcinoma and 7 cases of basaloid squamous carcinoma were included in this study, among which were 5 cases with cervical lymph node metastasis. These were distributed as 9 well-differentiated, 7 moderately, and 5 poorly differentiated cases. Immunohistochemical analysis using labeled streptavidin, biotin, and monoclonal antibody for α-SMA. <h3>Results</h3> Intense immunoexpression of α-SMA was observed in the anaplastic neoplasms that also was correlated with lymph node involvement. In contrast, well-differentiated cancer revealed only a mild reaction. <h3>Conclusions</h3> According to these findings, one could conclude that α-SMA can be used as a prognostic marker and potential target for cancer therapy.

A study of neoplastic study of gastrointestinal tumors

Background: Gastrointestinal tumors account for a large proportion of all neoplasms. The tumors of the Gastrointestinal tract pose a major problem in oncology and also are a major cause of apprehension in patient with the abdominal complaint in whom the fear of the cancer is the greatest. There is world wide variation in the distribution of these neoplasm, which appear largely due to exogenous factors rather than genetic. Objectives: to determine the relative frequency of various histopathologic types of tumors of eosophagus, stomach and intestines, and knowledge about their prognosis will aid the clinician in effective management of patient. Methodology: It was a prospective observational study carried after permission of the institutional ethics committee. All biopsies and resected specimens of GIT with neoplastic lesions were examined for gross lesions. All specimens studied under light microscopy and tumors were classified according to the WHO International classification of Tumors of the esophagus, stomach and intestines. Results: Gastrointestinal tumor distributed throughout all age group with maximum in 5th and 6th decade of life with male:female ratio was 1.67:1. Out of 18 cases of esophageal tumors, 16 were of squamous cell carcinoma, 1 case of adenosquamous carcinoma and 1 case of basaloidsquamous carcinoma. Majority of cases of gastric tumors occurred in pylorus followed closely by body of the stomach. Out of 18 cases of colorectal carcinoma, 12 cases were adenocarcinoma, 3 were mucinous adenocarcinoma, 2 cases of Signet ring cell carcinoma and 1 case of Malignant melanoma. Conclusion: Tumors of the gastrointestinal tract show a wide variation in the histological type making the histopathological examination a must in the diagnosis of these tumors. Early diagnosis and treatment is beneficial for better management and is imperative in providing better quality of life to the patient.

肝切除後4年3カ月生存中の食道類基底細胞癌肝転移再発の1例

食道類基底細胞癌はまれな疾患で，予後は不良とされている．さらに肝転移巣を切除後，長期生存を得られた症例はまれである．今回，われわれは原発巣切除後に肝転移を2度切除し，長期生存を得られた症例を経験したので報告する．症例は59歳の男性．嚥下時つかえ感を主訴に来院し，精査を行った結果，胸部下部食道に2型腫瘍を認めた．食道亜全摘術を施行し，二期的再建前に肝S7に転移性肝腫瘍の出現を認めた．再建と同時に肝部分切除術を施行し，食道類基底細胞癌の肝転移と診断した．経過観察中に再度肝S7に腫瘤性病変が出現したため，化学療法を施行後に肝S7亜区域切除術を行った．術後化学療法は施行せず経過観察を行っているが，原発巣切除後5年2カ月（転移性肝腫瘍切除後4年3カ月）経過した現在も無再発生存中である．

Basaloid squamous carcinoma of the supraglottic larynx with neuro-endocrine features

Basaloid squamous carcinoma (BSC) is a rare aggressive variant of squamous cell carcinoma and occurs mainly at the larynx, oropharynx and tongue of the head and neck region. Neuro-endocrine differentiation of BSC is further rare occurrence in laryngeal cancers. We report here a case of BSC of supraglottic larynx with neuro-endocrine differentiation, which was treated by radiotherapy and its response to treatment.

Carcinome épidermoïde basaloïde et à cellules fusiformes avec métaplasie osseuse se présentant comme un polype de l’hypopharynx

We report a case of basaloid squamous carcinoma with a spindle cell component of the hypopharynx, in a 61-years-old-man. An excisional biopsy of a pedonculated and polypoid tumour was performed by endoscopy. The histologic examination revealed a biphasic tumour with both a basaloid carcinomatous and a spindle cell component. Focally, osseous metaplasia was seen. The spindle cell component demonstrated immunoreactivity with the p63 epithelial marker. The patient was treated with chemotherapy followed by radiotherapy. The patient has been free of disease for one year. It's the ninth case reported in the literature of a biphasic carcinoma with both a basaloid squamous and a spindle cell component and the first case with osseous metaplasia.

Basaloid Squamous Cell Carcinoma of the Esophagus: Report of Two Cases

Basaloid squamous cell carcinoma is an uncommon malignancy of the esophagus. We present two cases of basaloid squamous carcinoma of the esophagus. Both tumors histologically consisted of solid cell nests and displayed focal immunoreactivity for type IV collagen. The nests comprised pseudoglandular structures containing myxoid matrix. Transthoracic esophagectomy with lymph node dissection was performed in both patients. The patients had uneventful postoperative courses. One patient showed no evidence of recurrence or metastasis in the 6-month postoperative period, and the other patient died of lung metastasis 28 months after the primary treatment.

Basaloid Squamous Carcinoma of the Hypopharynx With an Extensive Spindle Cell Component Exhibiting a Pedunculated Polypoid Mass

We report a case of basaloid squamous carcinoma of the hypopharynx with an extensive spindle cell component in an 82-year-old man. The tumor (4.0 x 2.5 x 2.2 cm) was a pedunculated polypoid mass that was attached to the left pyriform sinus. Histologically, most (70%) of the tumor was composed of malignant spindle cell proliferation, and the rest (30%) was basaloid squamous carcinoma. Some of the spindle cells were positive for cytokeratins. The preoperative histologic diagnosis was difficult because the endoscopic biopsy specimens showed only spindle cell proliferation. This is an unusual presentation of basaloid squamous carcinoma of the head and neck.

喉頭に発生した類基底細胞癌例

Basaloid-squamous carcinoma (BSC) is a high grade, aggressive variant of Squamous cell carcinoma (SCC). The incidence of BSC of the head and neck generally has been low, although the number of case reports has increased in recent years.We report a case of BSC localized in the larynx. The biopsy specimen of the larynx suggested SCC initially, but further biopsy ultimately revealed BSC, subsequent endoscopy revealed simultaneous SCC in the esophagus. The patient was treated with surgical resection of the larynx, hypopharynx, and esophagus, and dissection of the neck bilaterally. However, bilateral lung metastasis appeared 3 months after surgery, and he died 5 months later.BSC of the head and neck region is a highly malignant neoplasm with frequent metastatic complication. Therefore, it is important to distinguish BSC from conventional SCC. Even if it is an early stage, in addition to resection of the primary neoplasm and dissection of the neck, it is essential to perform powerful whole body treatment.

Basaloid squamous carcinoma of oral cavity: a histologic and immunohistochemical study

Basaloid squamous carcinoma (BSC) is an aggressive variant of squamous cell carcinoma (SCC) with a predilection for the upper aerodigestive tract. In the English literature, approximately 40 cases of BSC have been described in the oral cavity. BSC has frequently been confused with adenoid cystic carcinoma (ACC), basal cell adenocarcinoma, and undifferentiated SCC. The purpose of the investigation was to examine the histological features and immunohistochemical expression of differentiation-related substances, including cytokeratin (CK) subtypes, vimentin, S-100, chromogranin, laminin, and type IV collagen, for the characterization of biological features of these tumours. We studied three cases of BSC of the oral cavity, three cases of ACC, and one case of basal cell adenocarcinoma. Well-differentiated and undifferentiated SCCs were also studied for comparison. The BSCs showed many histopathologic similarities to cases previously reported. Among the CK subtypes analyzed, CK14 was the only subtype expressed by all basaloid cells of BSC. Potentially useful for the differential diagnosis was the finding of CKs 7 and 19 expression in the basaloid cells of ACC, and CKs 7 and 8 in basal cell adenocarcinoma. In BSCs, laminin and type IV collagen were found in the microcystic spaces between basaloid cells, but neither ACCs nor basal cell adenocarcinoma showed this feature. These data suggest that immunohistochemical findings are helpful in distinguishing BSC of the oral cavity from other histopathologically similar tumours.

Basaloid squamous carcinoma of the oral cavity: Report of 2 cases and study of AgNOR, PCNA, p53, and MMP expression

Basaloid squamous carcinoma (BSC) is an uncommon aggressive variant of squamous cell carcinoma (SCC) with a predilection for the head and neck. In the English literature, approximately 40 cases of BSC in the oral cavity have been described. In this study, the clinicopathologic features of 2 cases of BSC affecting the buccal mucosa are reported. In addition, we compare the proliferative and invasive potential of BSC cells with that of poorly differentiated SCC cells matched for age, sex, site, and TNM status. Proliferative activity was studied through use of the argyrophilic nuclear organizer region (AgNOR) method and immunohistochemical quantification of proliferating cell nuclear antigen (PCNA). The invasive potential was evaluated through use of the semiquantitative reverse transcriptase-polymerase chain reaction (RT-PCR) for matrix metalloproteinases (MMPs). Alterations of p53 were also investigated through use of immunohistochemistry. The tumors showed many clinical and histopathologic similarities to tumors in cases previously reported. The AgNOR and PCNA indices were significantly higher in the 2 cases of BSC than in the cases of SCC. Immunostaining for p53 protein showed a higher percentage of positive cells and more intense staining in the BSC tissues than in the SCC tissues. RT-PCR studies clearly demonstrated that the expression of MMP-1, MMP-2, and MMP-9 was higher in cells from BSCs than in cells from SCCs. Taken together, the data described here are compatible with the concept that BSC has a more aggressive biologic behavior than conventional SCC. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2001;91:563-9)

Basaloid squamous carcinoma of the oesophagus: a distinct neoplasm with multipotential differentiation.

Basaloid squamous carcinoma (BSC) is an uncommon variant of squamous cell carcinoma, with its prevalent sites being the hypopharynx, tongue base and larynx. In the oesophagus, BSC is rarer than in the head and neck region. This study was aimed to document the clinicopathological features of BSCs of the oesophagus, and to present their relative incidence and immunohistochemical findings. Eighteen cases of BSC of the oesophagus, comprising 3.6% of 502 oesophageal carcinomas, were reviewed for their pathological and clinical features, and examined for the immunohistochemical expression of neuroendocrine markers, cytokeratins, p53, pRb and bcl-2. Oesophageal basaloid squamous carcinomas tended to be biphasic or multiphasic carcinomas, most commonly with basaloid and squamous components (eight cases), or with additional adenocarcinoma (three cases) or with small cell carcinoma (two cases). Each component was microscopically clearly distinguishable from the others, and metastasized separately, chiefly the basaloid component. The remaining five cases were apparently pure basaloid carcinomas, being characterized by lobules and nests of monotonous round undifferentiated cells with frequent comedo necrosis. They resembled, but were differentiated from, the small cell carcinoma on the basis of neuroendocrine markers and cytokeratin expression. p53, pRb and bcl-2 oncoprotein, which are known to normally present in the basal/parabasal cells of the oesophageal epithelium, were detected in 40-50% of cases, with a heterogeneous expression pattern. The patients were all male, with the age ranging 47-74 years (median 57) and presented at variable stages. The plotted 3 years survival rate was 51%, and the immunohistochemical expression of p53, pRb and bcl-2 was not related to the survival of the patients. Basaloid squamous carcinoma of the oesophagus is a peculiar neoplasm with a capacity of multidirectional differentiation, often with heterogeneous oncogene expression, probably reflecting the pluripotential stem cell origin.

Clinicopathologic study of basaloid squamous carcinoma of the upper aerodigestive tract.

The clinicopathologic and immunohistochemical characteristics of nine cases of basaloid squamous carcinoma (BSC) of the upper aerodigestive tract are reported, along with the results of an in situ hybridization for human papilloma virus (HPV) DNA. The cases were selected through a review of 237 head and neck carcinomas, and were located in the supraglottic larynx (5), hypopharynx (2), and the base of tongue (2). The patients were 7 males and 2 females with the mean age of 62. BSCs were histologically characterized by lobules and nests of basaloid cells with scanty cytoplasm, comedonecrosis and adenoid features, and by concomitant presence of squamous cell carcinoma. Immunohistochemically, all BSCs showed positivity for high molecular weight cytokeratin (HMW CK) with heterogeneous or diffuse staining pattern, but lacked reactivity for neuroendocrine markers and bcl-2 oncoprotein. No HPV DNA was detected in BSCs. This study reaffirms that BSC is a rare carcinoma with a peculiar topographic distribution and distinct pathologic features.

Basaloid squamous carcinoma of esophagus:a clinicopathological, immunohistochemical and electron microscopic study of sixteen cases.

AIM:To further clarify the clinicopathological, immunohistochemical and electron microscopic features, and prognostic aspect of basaloid squamous carcinoma (BSC), a rare esophageal carcinoma.METHODS:We reviewed 763 documented cases of esophageal malignancies from year (1977-1996) from our hospital, and discovered 16 (2.1%) cases of BSC. The clinicopathological features of these cases were evaluated. Immunohistochemistry (S-P method), histochemical stains, and electron microscopy were used to further characterize the neoplasm.RESULTS:The tumors were classified into stages I(n =1), II A (n =6), II B(n =2), II (n =5), and IV(n =2) according to the criteria of the UICC TNM classification system of malignant tumors (1987). Most neoplasms were located in the mid third of the esophagus. Grossly, they had a similar appearance of conventional esophageal carcinoma, but showed a typical cytoarchitectural pattern of BSC histologically. The most important histologic feature of this tumor is carcinoma with a basaloid pattern, intimately associated with squamous cell carcinoma, dysplasia, or focal squamous differentiation. The basaloid cells were round to oval in shape with scant cytoplasm, arranged mainly in the form of solid, smooth-contoured lobules with peripheral palisading.A panel of immunostains were used for the basaloid component of the tumor with the following results:CK(Pan) 14/16(+); EMA 16/16 (+); Vimentin 4/16 (+); S-100 protein 7/16 (+). CEA and smooth muscle actin were negative. Electron microscopy (EM) revealed that the basaloid cells were poorly differentiated, with a few desmosomes and fibrils, and numerous free and polyribosome. Of the 11 patients with adequate follow-up 8 died within 2 years, with an average survival time of 16.2 months.No stage II,III or IV cases survived beyond 5 years. The one-year survival rate was 60% and two-year 20%.CONCLUSION:The BSC of esophagus is a distinct clinicopathological entity with poor prognosis. The cellular differentiation and biologic behavior of esophageal BSC were assumed to occupy a station intermediate between that of conventional squamous cell carcinoma and small undifferentiated cell carcinoma.

Basaloid squamous carcinoma of the larynx: Report of a case

Basaloid squamous carcinoma (BSC) is a rare neoplasm. We present a case of basaloid squamous carcinoma of the larynx in a 57-year-old male patient. The diagnosis before treatment was supraglottic carcinoma (T3N1MO) and biopsy of the larynx revealed a poorly differentiated squamous cell carcinoma. Total laryngectomy and right radical neck dissection were performed, and pathological studies of a specimen removed from the larynx revealed BSC of the larynx. The patient's postoperative progress was uneventful, however, 12 months later he developed lung metastasis of the left side. The patient underwent partial resection of the lung. He developed recurrence of lung metastasis 6 months later. Chemotherapy with cisplatin (CDDP) and vindesine sulfate (VSD) was administered in two courses, but the efficacy was evaluated as no change (NC). At present, 26 months after the first visit, he has been asymptomatic with lung metastasis, and there was no evidence of recurrence in the neck.

Basaloid Squamous Cell Carcinoma of the Esophagus Immunohistochemistry and Flow Cytometric DNA Analysis in Two Cases

Basaloid squamous cell carcinoma is a well-established anatomopathologic entity of the upper aerodigestive tract and is more aggressive than the conventional squamous cell carcinoma. Only seven cases of this variant have been reported in the esophagus. Two cases of basaloid squamous carcinoma in the middle and lower third of the esophagus in two men aged 59 and 60 years are presented. Tumor stages were IIA and IV at the time of total esophagectomy, and survival times were 34 and 4 months, respectively. Histologically, the two tumors were composed of nests of cells with a basaloid appearance, the first with a predominantly cribriform pattern and the second with a solid lobular pattern and intense comedonecrosis; in the adjacent squamous epithelium of both tumors, carcinoma in situ was observed focally. Immunoreactivity was poor for high-molecular-weight cytokeratins and absent for those of low molecular weight. Staining for epithelial membrane antigen was weakly positive, enolase was moderately positive, and no reactivity for carcinoembryonic antigen, S100 protein, and chromogranin was observed. The flow cytometric analysis showed both tumors to be hyperdiploid with an index of cell proliferation of over 50%.

Basaloid squamous carcinoma of the oral cavity: Report of a case

A case of basaloid squamous carcinoma that involves the posterior buccal mucosa is described. The major histopathologic feature is a carcinoma with a basaloid pattern in association with squamous differentiation. The basaloid cells exhibit large and vesicular nuclei and eosinophilic clear or vacuolated cytoplasm. Cells are distributed in cords, trabeculae, or lobules that occasionally show glandular arrangement. The majority of the tumor cells are positive for keratin and a large group of cells distributed in glandular arrangement are positive also for vimentin.