Basaloid squamous cell carcinoma of the maxillary gingiva: A case report and review of the literature

Abstract

Basaloid squamous cell carcinoma (BSCC) is a rare, but distinct histologic variant of squamous cell carcinoma in the head and neck region. It is considered to have a poor prognosis due to its aggressive behavior and tendency to metastasize. The usual sites of BSCC are the floor of the mouth, hypopharynx and base of the tongue, and according to the English-language literature its presentation in the gingiva is somewhat uncommon. In the current report, the unusual case of a 40-year-old male is presented; the patient exhibited a painless irregular mass in the maxillary gingiva, which infiltrated the maxillary sinus, as observed by computed tomography. Hematoxylin and eosin-stained sections revealed a diagnosis of BSCC with typical central necrosis in the cancer nests, which contained basaloid and squamous cells. Immunohistochemistry revealed that p63 was weakly positive, high molecular weight cytokeratin (CK) was focally positive, and S-100, CK7, CK14 and vimentin were negative. It must be noted that histopathology results may be incorrectly interpreted as adenoid cystic carcinoma, undifferentiated carcinoma and basal cell adenocarcinoma.

Basaloid Squamous Cell Carcinoma of the Head and Neck: Subclassification into Basal, Ductal, and Mixed Subtypes Based on Comparison of Clinico-pathologic Features and Expression of p53, Cyclin D1, Epidermal Growth Factor Receptor, p16, and Human Papillomavirus

“…These have been described as useful markers for differentiating BSCC from other histologically similar tumors including basal cell carcinoma with squamous metaplasia, adenoid cystic carcinoma, and neuroendocrine carcinoma. The CK7 expression rate has varied depending on the report (0%–53%) [ 8 , 10 , 11 , 13 , 14 ].…”

Basaloid squamous cell carcinoma: Report of two rare cases and review of literature

“…BSCC is a rare and malignant tumor that presents in the head-and-neck region, including the oral mucosa, and has been defined as an aggressive and distinct variant of SCC, which is composed of basaloid and squamous components, according to the World Health Organization. [ 9 ]…”

“…The clinical features of the BSCC cases that presented in the gingiva and retromolar trigone are reviewed and summarized in Tables 1 and 2 respectively. [ 9 10 11 12 ] Among the cases reported on gingiva two patients were female and eight were male with an age range of 40–79 years (mean age, 60.1 years). The most frequent site of origin was the mandible ( n = 9) followed by the maxilla ( n = 2).…”

“…showed that patients with SCC were associated with notably higher survival rates when compared with patients with BSCC. [ 9 ]…”

“…It is advocated that immunotherapy elicited an improved treatment effect when compared with radiotherapy alone and resulted in a reduced mortality rate. [ 9 ]…”