Application of Sentinel Lymph Node Biopsy in Cutaneous Basosquamous Carcinoma

Jankovic, Irena; Kovačević, Predrag; Visnjic, Milan; Janković, D; Binić, Ivana; Janković, Aleksandar; Ilić, Ivan

doi:10.5021/ad.2011.23.s1.s123

Cited by 14 publications

(8 citation statements)

References 8 publications

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“…Selective sentinel node biopsy should be considered even in absence of palpable lymphadenopathies in order to manage a proper staging of this entity. 8 In conclusion, we suggest that all dermatologists should be aware that BSC may not be focused in the same terms as BCC and SCC. Individualized guidelines should be employed.…”

Section: Discussionmentioning

confidence: 83%

Facial extensive ulcer

Fernández‐Crehuet¹,

Ruiz‐Villaverde²

2016

Rev. Assoc. Med. Bras.

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suMMaryBasosquamous carcinoma (BSC), as described in 1910, is a distinctive variety of skin cancer and its etiology and pathological characteristics have generated much controversy over the years. Currently, BSC is considered a basal cell carcinoma (BCC) subtype with aggressive behavior and greater tendency for recurrence and metastases. We present a clinical case recently reported in our unit.Keywords: skin neoplasms, skin ulcer.Basosquamous carcinoma (BSC), as described in 1910, is a distinctive variety of skin cancer and its etiology and pathological characteristics have generated much controversy over the years.1 Currently, BSC is considered a basal cell carcinoma (BCC) subtype with aggressive behavior and greater tendency for recurrence and metastases. caseA 52-year-old male presented with a 6-year history of an impressive extensive ulcer on his right cheek ( Figure 1). It appeared over the old scar of a previous BCC excised ten years ago. It had painless steady increase in size with progressive difficulty in ocular movements and epiphora. A facial CT scan demonstrated a destruction of the right maxilla and nasal bone with no lymphadenopathies in the head and neck regions. Blood cell counts, urea, sedimentation rate, electrolytes, urinalysis tests were within reference ranges and antinuclear and anti-neutrophil cytoplasmic antibodies (ANCA) were negative. Mycological and bacterial cultures were also negative. A skin biopsy was performed and sent for hematoxylin-eosin and immunohistological staining (Figure 2). discussionThe incidence of BSC is between 1.5-2.7% in the largest studies reported.2 Local aggressive growth pattern and high potential for distant metastases are the main concerning facts. The rate of local recurrence of the BSC is 45%, almost twice as much as squamous cell carcinoma (SCC) and BCC. 3 This rare skin carcinoma has a metastatic rate of 5-8.4%. Prognostic factors for recurrence include positive resection margins, lymphatic invasion, perineural invasion and male gender. 4 Clinical image of the lesion is non-specific but long--standing time of evolution is a common feature in all the patients reported. The majority of these tumors arise on the head and the neck (80%), the central face and perinasal areas being the most prevalent locations. 5Histological examination exhibits findings of both BCC and SCC with a transition zone. It is not clear if BSC develops de novo or evolves from a pre-existing lesion, but the "squamatization theory" is the most commonly accepted. Unfortunately, the patient's previous BCC that was excised 10 years before could not be re-evaluated. Immunohistochemical stains have helped to a better characterization of BSC. Areas of BCC are Ber-EP4, AE1 and AE3 positive. In contrast, CAM5.2 and a variable positivization of epithelial membrane antigen are identified in the SCC areas. Ber-EP4 stain is gradually negative in the transition zone. Non-prospective trials to compare the different therapeutic regimes to approach BSC are available. There are

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Section: Discussionmentioning

confidence: 83%

Facial extensive ulcer

Fernández‐Crehuet¹,

Ruiz‐Villaverde²

2016

Rev. Assoc. Med. Bras.

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“…As inguinal lymph node metastases are extremely rare and only 10 cases have been reported in the literature, a routine lymphadenectomy is not recommended. However, cases of successful sentinel lymph node sampling to detect nodal metastasis in BCC, particularly basosquamous cell carcinoma, have been published [10]. Further research is required to determine which patients would benefit from this approach, in particular those with lesions measuring >20 mm and/or perineural/lymphatic invasion [11].…”

Section: Discussionmentioning

confidence: 99%

Inguinal Metastasis from Basal Cell Carcinoma of the Vulva

et al. 2019

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Vulval basal cell carcinomas (BCC) are an important differential diagnosis of painful, itchy vulval lesions, which can occur at all ages but commonly affect women in their senium. BCC tend to grow locally in an invasive and destructive pattern and seldom metastasize. Here we describe the rare case of inguinal metastasis in a 70-year-old woman with vulval BCC who was treated with radical hemivulvectomy, bilateral inguinal node sampling and adjuvant external beam radiotherapy. We discuss the clinical management of vulval BCC and provide an overview of the previously reported cases in the literature.

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“…SLNB has been a standard method for assessing occult metastasis in regional lymph nodes in various cancers . As far as we know, there have been only two reports on SLNB for BCC with lymph node metastasis because of the exceedingly low rates of metastasis . Those two cases were infiltrating BCC on the right forearm in an 83‐year‐old man (no description of the tumor size) and BSC on the back (4 cm in size) in a 63‐year‐old man.…”

Section: Discussionmentioning

confidence: 99%

“…10 As far as we know, there have been only two reports on SLNB for BCC with lymph node metastasis because of the exceedingly low rates of metastasis. 11,12 Those two cases were infiltrating BCC on the right forearm in an 83-year-old man (no description of the tumor size) and BSC on the back (4 cm in size) in a 63-year-old man. In the present case, the tumor (5 cm in size) on the thigh infiltrated into the dermis deeply and the expression of Ber-EP4 was partly positive, suggesting a possibility of an aggressive nature of the tumor cells in BSC.…”

Section: Discussionmentioning

confidence: 99%

Metastatic basosquamous carcinoma detected by sentinel lymph node biopsy

Yoshida

Shiomi

Tahira

et al. 2013

The Journal of Dermatology

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We describe a rare case of basosquamous carcinoma (BSC) in a 69-year-old man. He had noticed a pigmented nodule on his left thigh. Dermoscopic examination showed ulceration at the center and non-typical leaf-like areas at the periphery. Linear-irregular vessels were also seen. He underwent tumor excision in addition to sentinel lymph node biopsy (SLNB). Histopathological examination revealed both features of basal cell carcinoma (BCC) and squamous cell carcinoma. The sentinel lymph node was positive for tumor cells. Immunostaining for Ber-EP4 was focally positive for invasive tumor cells. Although complete inguinal lymphadenectomy had been performed, multiple in-transit metastases around the primary lesion and left iliac lymph node metastasis developed after the operation. It is considered that BSC has a worse prognosis than BCC with a potential for metastasis. Based on the findings of previously reported cases and our case, SLNB may be applied for certain high-risk cases including BSC larger than 3 cm in size and careful follow up is recommended for patients with BSC.

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Application of Sentinel Lymph Node Biopsy in Cutaneous Basosquamous Carcinoma

Cited by 14 publications

References 8 publications

Facial extensive ulcer

Facial extensive ulcer

Inguinal Metastasis from Basal Cell Carcinoma of the Vulva

Metastatic basosquamous carcinoma detected by sentinel lymph node biopsy

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