Basal Cell Carcinomas Developing in Solid Organ Transplant Recipients

Kanitakis, Jean; Alhaj-Ibrahim, Lina; Euvrard, Sylvie; Claudy, A

doi:10.1001/archderm.139.9.1133

Cited by 60 publications

(54 citation statements)

References 31 publications

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“…For superficial BCC, treatment with photodynamic therapy, cryosurgery or laser surgery, imiquimod and topical 5-fluorouracil are alternatives to surgical excision. The prognosis of BCC does not seem to be worse in OTR compared to in the general population [22,25]. Recurrence after surgical excision has been observed in 10% of RTR [22].…”

Section: Epithelial Skin Neoplasmsmentioning

confidence: 99%

Skin Cancer in Organ Transplant Recipients

Kempf¹,

Mertz²,

Hofbauer

et al. 2013

Pathobiology

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Organ transplant recipients (OTR) are at a significantly increased risk for developing a wide variety of skin cancers, particularly epithelial skin cancer, Merkel cell carcinoma and Kaposi's sarcoma. Melanoma, skin adnexal neoplasm and cutaneous lymphomas are also more common in OTR and may differ in their clinicopathologic presentation from tumors in immunocompetent patients. The accuracy of clinical diagnosis of suspected premalignant and malignant skin lesions in OTR is modest. Therefore, histopathological diagnosis is an essential element for the diagnostic workup of skin cancers and, in addition, provides important information on prognosis. Squamous cell carcinoma and intraepithelial neoplasias (actinic keratosis, squamous cell carcinoma in situ or Bowen's disease) are the most common forms of skin cancer in OTR. The risk of Merkel cell carcinoma and Kaposi's sarcoma is dramatically increased in OTR. Merkel cell carcinoma shows a highly aggressive course. Kaposi's sarcoma tends to spread to extracutaneous sites. Primary cutaneous lymphomas developing after organ transplantation are rare. The spectrum of cutaneous B cell lymphomas in OTR, in particular, differs significantly from that of the general population, with a predominance of Epstein-Barr virus-driven posttransplant lymphoproliferative disorder. This review discusses the clinical and histopathological aspects of skin cancers in OTR, the impact of dermatopathological analysis on prognosis and the understanding of the pathogenesis of these neoplasms.

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Section: Epithelial Skin Neoplasmsmentioning

confidence: 99%

Skin Cancer in Organ Transplant Recipients

Kempf¹,

Mertz²,

Hofbauer

et al. 2013

Pathobiology

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“…Immunosuppressive treatment, age at the time of transplantation, male sex, skin type II, and environmental exposure to UV radiation are major risk factors in the development of non-melanoma skin cancer (NMSC) in organ transplant recipients [6,[16][17][18]. BCCs in transplant recipients develop at younger age, occur more frequently on extracranial locations, are more often of superficial type, have poorer inflammatory response and show slightly more frequent squamous differentiation compared with the nontransplanted population [21,25].…”

Section: Introductionmentioning

confidence: 99%

Differential expression of stromal MMP-1, MMP-9 and TIMP-1 in basal cell carcinomas of immunosuppressed patients and controls

et al. 2007

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Matrix metalloproteinases (MMPs) have an important role in the initiation, growth, and invasion of malignant tumors. Basal cell cancer (BCC) is the most common human malignancy. The risk of BCC is 10-16 times higher among organ transplant recipients compared with the nontransplanted population. The aim of this study was to compare the expression of several MMPs and their tissue inhibitors (TIMPs) in BCCs from kidney transplant recipients and controls. Expression of MMPs-1, -7, -8, -9, -10, -13, -26, and TIMPs-1 and -3 was evaluated by immunohistochemistry in 25 samples of BCC of kidney transplant recipients and 25 matched controls representing superficial and nodular subtypes. No significant differences were detected in MMP expression of BCC tumor cells between immunocompetent and immunodeficient patients. However, MMPs-1 and -9 and TIMP-1 were expressed more frequently in stromal macrophages in the BCCs of immunocompetent patients. When tumor subtypes were compared irrespective of the patient group, more MMP-1-positive fibroblasts and MMP-9-positive neutrophils were detected in the superficial subtype, while stromal MMP-10 expression was more abundant in nodular tumors. Our results suggest that abundant peritumoral expression of TIMP-1 in non-immunocompromised patients limits ECM degradation permissive for cancer cell migration.

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“…5 Subsequent studies confirmed the association between solid organ transplantation/immunosuppression and the development of SCC, BCC and other skin neoplasms. [6][7][8] The relative risk for such tumors in solid organ recipients is estimated to be 92 and 108 for women and men, respectively. 9 Bone marrow transplantation is associated with an increased incidence of secondary malignancies; conventional, myeloablated transplant recipients are at increased risk for malignant melanoma and SCC of the buccal cavity and skin.…”

Section: Introductionmentioning

confidence: 99%