Perianal Basal Cell Carcinoma: A Comparative Histologic, Immunohistochemical, and Flow Cytometric Study with Basaloid Carcinoma of the Anus

Abstract

Perianal basal cell carcinoma is a very rare tumor accounting for only 0.2% of the anorectal tumors. It must be distinguished from basaloid carcinoma of the anus, which resembles it histologically but shows a much more aggressive behavior, metastasizes early, and often proves fatal, thus requiring different therapy. Differential diagnosis of both entities by light microscopy may be difficult. Five cases of perianal basal cell carcinoma and five cases of basaloid carcinoma were studied by means of immunohistochemistry and flow cytometry. Some immunohistochemical markers, such as epithelial membrane antigen, carcinoembrionic antigen, and keratins, as well as the lectin Ulex europaeus agglutinin I stained basaloid carcinoma and were negative for basal cell carcinoma. In contrast, the monoclonal antibody Ber-EP4 seems to be a good marker for perianal basal cell carcinoma and useful in differentiating it from basaloid carcinoma of the anus. Basaloid carcinomas are associated with a significantly higher S-phase fraction than are perianal basal cell carcinomas (p < 0.01).

Basosquamous Carcinoma Behaviour in Relation to Basaloid Carcinoma

“…BSC is represent the most common skin cancer developing primarily in the sun exposed skin usually in the elderly patient [4,5]. Basal cell carcinoma can be classified into indolent growth subset including superficial, nodular and micro nodular BCC, and into aggressive growth variant including infiltrative, morpheaform (sclerosing) and basosquamous (metaatypical) BCC [6].…”

“…Basosquamous carcinoma (BSC) is a rare epithelial neoplasm with features of both basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) without a transition zone [1,2] and tend to be aggressive, and more likely to metastasize [3,4] as well as difficult to treat and has a poor prognosis [5]. Most common sites of occurrence of BSC are head and neck, mainly involving areas like the nose, ear and peri orbital areas although it can occur in other unusual site as in our case.…”

Giant Perianal Basal Cell Carcinoma: An Uncommon Localization: Case Report

“…3,5 Although male predominance is suggested in some series, other reports indicate that this predominance is still debatable. 6 BCC peaks at 6 th decade.…”

“…Although it constitutes 75% of the non-melanoma cutaneous malignancies, develops in the perianal region in less than 1% of cases. [1][2][3] To date, approximately 200 cases of perianal and genital BCC have been reported. 1,2 Because exposure to ultraviolet light remains the main causative factor in the pathogenesis of BCC, it more typically develops on skin surfaces that are exposed to sunlight, such as neck, face and head in 80% of patients.…”

“…Early diagnosis is life saving because of BCC in this localization is prone to metastasize early in the course of the disease, and tends to be fatal. 3 Surgical excision, curettage, electrodesiccation, CO 2 laser ablation, cryotherapy, radiotherapy, photodynamic therapy, immunotherapy (imGiant Perianal Basal Cell Carcinoma: An Uncommon Localization: Case Report A AB BS ST TR RA AC CT T Although basal cell carcinoma (BCC) is the most common cutaneous malignancy, it develops in the perianal region in only 1% of patients. However, BCC seems to be much more aggressive when it develops in the perianal and genital regions compared to other parts of the body.…”