Primary Cutaneous Carcinosarcoma of the Basal Cell Subtype Should Be Treated as a High-Risk Basal Cell Carcinoma

Abstract

Our case suggests that a cutaneous carcinosarcoma with an epithelial component composed of basal cell carcinoma can be regarded as a high-risk nonmelanoma skin cancer.

Cutaneous Carcinosarcoma: A Small Case Series and Review of the Literature of a Rare Skin Tumor

“…The outcomes of the two patients in our series were contrary to general prognostic factors, as Patient B presented earlier with a less aggressive histologic form of carcinoma and was without distant metastases, but ultimately succumbed to her disease. Along with Bourgeault et al, we agree that a cutaneous carcinosarcoma of the basaloid subtypes should be treated as a high-risk basal cell carcinoma [18]. In both cases, our patients presented later in the disease stage in part due to the negligence of nonhealing wounds, further emphasizing the need for increased awareness of such conditions.…”

Primary cutaneous biphasic sarcomatoid basal cell carcinoma with myoepithelial carcinoma differentiation: A new variant

“…In contrast, the lesion presented here shows unquestionable histological features of myoepithelial differentiation with metastatic potential due to the cytological atypia and the high mitotic rate. We believe that it should be recognized as a high‐risk BCC variant …”

“…We believe that it should be recognized as a high-risk BCC variant. 15 On the other hand, it has been demonstrated that cutaneous myoepithelial tumors harbor EWRS1 rearrangement with variable partners in an important subset of either benign (chondroid syringoma or myoepithelioma) and malignant cutaneous lesions (myoepithelial carcinoma), and therefore, they are genetically related to soft tissue, bone, and visceral myoepithelial tumors. 11,16 In summary, based on histological, immunophenotypical, and genetic findings, we report what to our knowledge is the first fully documented case of primary cutaneous biphasic sarcomatoid BCC with myoepithelial carcinoma differentiation, and we propose its inclusion as a new variant in the currently well-characterized spectrum of cutaneous myoepithelial lesions.…”

Erythematous and Ulcerated Plaque on the Left Temple

“…1 Primary cutaneous carcinosarcomas are uncommon, poorly understood, primary cutaneous tumors. 2,3 Characteristic of this tumor, cytokeratins highlight the epithelial component while vimentin highlights the mesenchymal component. 4 Histologically, the sarcomatous components of PCCS often are highly variable, with an absence of transitional areas within the epithelial component, which frequently resembles basal cell carcinoma and/ or SCC.…”

“…10 Risk factors associated with poorer prognosis include tumors with adnexal subtype, age less than 65 years, rapid tumor growth, a tumor greater than 20 mm at presentation, and a long-standing tumor lasting up to 30 years. 2,4 Although wide local excision and Mohs micrographic surgery (MMS) both have been utilized successfully, MMS has been shown to result in a cure rate of greater than 98%. 6 Atypical fibroxanthoma (AFX) is a cutaneous tumor of fibrohistiocytic mesenchymal origin that typically manifests on sun-damaged skin in elderly individuals.…”