Basaloid Squamous Cell Carcinoma of the Head and Neck: Clinicopathological Features and Differential Diagnosis

Barnes, Leon; MacMillan, Christina; Ferlito, Alfio; Rinaldo, Alessandra; Altavilla, Giuseppe; Doglioni, Claudio

doi:10.1177/000348949610500115

Cited by 119 publications

(73 citation statements)

References 31 publications

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“…Adenosquamous carcinoma (ASC) has an admixture of squamous cell carcinoma and adenocarcinoma, features absent in STACC. The surface epithelium with dysplasia, in situ carcinoma or various proportions of squamous differentiation in addition to peripheral nuclear palisading are lacking in STACC [149]. Neuroendocrine carcinoma (small cell or large cell types) tend to be more destructive clinically, with cells showing a high nuclear to cytoplasmic ratio, salt-and-pepper nuclear chromatin distribution, high mitotic rate and tumor necrosis.…”

Section: Immunohistochemical Studiesmentioning

confidence: 99%

Sinonasal Tract and Nasopharyngeal Adenoid Cystic Carcinoma: A Clinicopathologic and Immunophenotypic Study of 86 Cases

Thompson

Penner

Ho³

et al. 2013

Head and Neck Pathol

119

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'Primary sinonasal tract and nasopharyngeal adenoid cystic carcinomas (STACC) are uncommon tumors that are frequently misclassified, resulting in inappropriate clinical management. Eighty-six cases of STACC included 45 females and 41 males, aged 12-91 years (mean 54.4 years). Patients presented most frequently with obstructive symptoms (n = 54), followed by epistaxis (n = 23), auditory symptoms (n = 12), nerve symptoms (n = 11), nasal discharge (n = 11), and/or visual symptoms (n = 10), present for a mean of 18.2 months. The tumors involved the nasal cavity alone (n = 25), nasopharynx alone (n = 13), maxillary sinus alone (n = 4), or a combination of the nasal cavity and paranasal sinuses (n = 44), with a mean size of 3.7 cm. Patients presented equally between low and high stage disease: stage I and II (n = 42) or stage III and IV (n = 44) disease. Histologically, the tumors were invasive (bone: n = 66; neural: n = 47; lymphovascular: n = 33), composed of a variety of growth patterns, including cribriform (n = 33), tubular (n = 16), and solid (n = 9), although frequently a combination of these patterns was seen within a single tumor. Pleomorphism was mild with an intermediate N:C ratio in cells containing hyperchromatic nuclei. Reduplicated basement membrane and glycosaminoglycan material was commonly seen. Necrosis (n = 16) and atypical mitotic figures (n = 11) were infrequently present. Pleomorphic adenoma was present in 9 cases; de-differentiation was seen in two patients. Immunohistochemical studies showed positive reactions for pan-cytokeratin, CK7, CK5/6, CAM5.2, and EMA, with myoepithelial reactivity with SMA, p63, calponin, S100 protein and SMMHC. CD117, CEA, GFAP and p16 were variably present. CK20 and HR HPV were negative. STACC needs to be considered in the differential diagnosis of most sinonasal malignancies, particularly poorly differentiated carcinoma, olfactory neuroblastoma and pleomorphic adenoma. Surgery (n = 82), often accompanied by radiation therapy (n = 36), was generally employed. A majority of patients developed a recurrence (n = 52) 2-144 months after initial presentation. Overall mean follow-up was 19.4 years (range 0.4-37.5 years): 46 patients died with disease (mean 6.4 years); 5 were alive with disease (mean 5.4 years), and 35 patients were either alive or had died of unrelated causes (mean 16.3 years). ACC of the SNT is uncommon. Recurrences are common. The following parameters, when present, suggest an increased incidence of either recurrence or dying with disease: mixed site of involvement, high stage disease (stage IV), skull base involvement, tumor 123Head and Neck ) 8:88-109 DOI 10.1007 recurrence, a solid histology, perineural invasion, bone invasion, and lymphovascular invasion.

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Section: Immunohistochemical Studiesmentioning

confidence: 99%

Sinonasal Tract and Nasopharyngeal Adenoid Cystic Carcinoma: A Clinicopathologic and Immunophenotypic Study of 86 Cases

Thompson

Penner

Ho³

et al. 2013

Head and Neck Pathol

119

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“…2 The differential diagnosis of this entity includes adenoid cystic carcinoma, neuroendocrine carcinoma, basal cell adenocarcinoma, adenosquamous carcinoma, and common (well differentiated, moderately differentiated, and poorly differentiated) SCC. 3,4 Because the initial diagnosis can be difficult to make, especially on biopsy materials, immunohistochemical studies have been attempted with minimal success to identify specific markers for BSCC for problematic cases. 4,5 Proper classification is warranted, because the biologic behavior and treatment response of BSCC seem to differ from that of adenoid cystic carcinoma and other histologic types.…”

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confidence: 99%

Outcomes after radiotherapy for basaloid squamous cell carcinoma of the head and neck

Thariat

Ahamad

El‐Naggar

et al. 2008

Cancer

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BACKGROUND.Basaloid squamous cell carcinoma (BSCC) is an uncommon, high‐grade variant of squamous cell carcinoma (SCC) of the head and neck. Its poorer prognosis compared with common SCC remains controversial. The authors investigated the outcomes of patients with BSCC who received radiotherapy and compared them with the outcomes of patients with SCC.METHODS.From 1994 to 2004, 1007 patients received radiotherapy for head and neck carcinoma with lymph node involvement. The histologic types consisted of 51 BSCC, 431 poorly differentiated SCC (PSCC), and 525 well or moderately differentiated SCC (WMSCC). A case–control analysis was performed with BSCC matched against both PSCC and WMSCC to compare disease‐control and survival rates.RESULTS.Patients with BSCC received treatment modalities similar to those received by patients with SCC: They received induction chemotherapy (12%) or concurrent chemotherapy (33%), and a median radiation dose of 70 Gray. Posttreatment viable tumor was present in 44%, 13%, and 28% of neck dissection specimens from patients with BSCC, PSCC, and WMSCC, respectively. The 5‐year disease‐free survival rates (63%, 77%, and 76%, respectively) and overall survival rates (85%, 70%, and 71%, respectively) demonstrated no statistically significant differences for BSCC, PSCC, or WMSCC, respectively.CONCLUSIONS.In this study, a poorer prognosis could not be demonstrated for irradiated patients with BSCC compared with either PSCC or WMSCC. All patients in this study had positive lymph node status, and the majority of patients (84%) had oropharyngeal cancer. The BSCC cohort did have a relatively high rate of viable tumor in their posttreatment neck dissections, and they had a relatively high rate of distant disease. On the basis of the high rate of lung metastases and the possibility of efficient salvage, the authors recommend obtaining a chest computed tomography scan during initial staging and follow‐up. Cancer 2008. © 2008 American Cancer Society.

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“…The identification of areas of conventional squamous cell carcinoma within the basaloid tumor pattern and a cribriform growth pattern is helpful in differentiating between these two tumors. Furthermore, BSCC frequently demonstrates a greater degree of cytologic atypia and mitotic activity and, more importantly, does not typically stain positively with neuroendocrine markers [64][65][66].…”

Section: Discussionmentioning

confidence: 99%

Moderately Differentiated Neuroendocrine Carcinoma (Atypical Carcinoid) of the Parotid Gland: Report of Three Cases with Contemporary Review of Salivary Neuroendocrine Carcinomas

Said-Al-Naief

Sciandra

Gnepp

2013

Head and Neck Pathol

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Primary neuroendocrine carcinomas (NECs) of the salivary glands are rare. Most reported NECs in that region are small cell carcinomas with few cases of large cell undifferentiated carcinoma and typical carcinoid tumors. Only two moderately differentiated NECs (atypical carcinoid tumors) have been previously reported. In the current series, the authors report three additional moderately differentiated NECs (atypical carcinoid tumors) of the parotid gland; two occurred in women and one in a man. All patients were initially treated with parotidectomy, with selective lymph node excision in one, and radiation therapy in another. Follow-up was available for two cases (18 and 79 months). One patient had two local recurrences, developing lymph node and liver metastases requiring further surgery and chemotherapy. Currently, she is alive with disease, on supportive care. The second patient is alive with no signs of recurrence. Patients' work-up excluded the possibility of metastatic NECs to the salivary glands in all cases. Histologically, the tumors demonstrated infiltrating nests, cords and trabeculae of round, oval to spindle shaped cells with moderate to focally abundant eosinophilic cytoplasm, small to prominent nucleoli and chromatin stippling. Scattered rosette-like structures were prominent in one tumor. The highest mitotic counts for the three tumors ranged from 5 to 8 mitotic figures/10hpfs. Necrosis, focal but distinct, was noted in two tumors, vascular invasion in two tumors and perineural invasion in one tumor. Immunohistochemical staining was diagnostic of neuroendocrine carcinoma, showing uniform positive labeling with broad-spectrum cytokeratin (with a paranuclear punctuate pattern in one case), chromogranin and synaptophysin antibodies. CK20 was negative in two tumors and stained rare cells (\1 %) in the third.

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Basaloid Squamous Cell Carcinoma of the Head and Neck: Clinicopathological Features and Differential Diagnosis

Cited by 119 publications

References 31 publications

Sinonasal Tract and Nasopharyngeal Adenoid Cystic Carcinoma: A Clinicopathologic and Immunophenotypic Study of 86 Cases

Sinonasal Tract and Nasopharyngeal Adenoid Cystic Carcinoma: A Clinicopathologic and Immunophenotypic Study of 86 Cases

Outcomes after radiotherapy for basaloid squamous cell carcinoma of the head and neck

Moderately Differentiated Neuroendocrine Carcinoma (Atypical Carcinoid) of the Parotid Gland: Report of Three Cases with Contemporary Review of Salivary Neuroendocrine Carcinomas

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