251
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Ferlito A, Rinaldo A, Devaney KO, Devaney SL, Milroy CM. Impact of phenotype on treatment and prognosis of laryngeal malignancies. J Laryngol Otol 1998; 112:710-4. [PMID: 9850312 DOI: 10.1017/s0022215100141556] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
An overview of the impact of the phenotype on treatment and prognosis of different laryngeal malignancies is presented.
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MESH Headings
- Carcinoid Tumor/mortality
- Carcinoid Tumor/therapy
- Carcinoma, Adenoid Cystic/mortality
- Carcinoma, Adenoid Cystic/therapy
- Carcinoma, Basal Cell/mortality
- Carcinoma, Basal Cell/therapy
- Carcinoma, Mucoepidermoid/mortality
- Carcinoma, Mucoepidermoid/therapy
- Carcinoma, Squamous Cell/mortality
- Carcinoma, Squamous Cell/therapy
- Carcinoma, Verrucous/mortality
- Carcinoma, Verrucous/therapy
- Chondrosarcoma/mortality
- Chondrosarcoma/therapy
- Humans
- Laryngeal Neoplasms/mortality
- Laryngeal Neoplasms/therapy
- Lymphoma/mortality
- Lymphoma/therapy
- Melanoma/mortality
- Melanoma/therapy
- Survival Rate
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Affiliation(s)
- A Ferlito
- Department of Otolaryngology-Head and Neck Surgery, University of Udine, Italy.
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252
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Yu GY, Ubmüller J, Donath K. Membranous basal cell adenoma of the salivary gland: a clinicopathologic study of 12 cases. Acta Otolaryngol 1998; 118:588-93. [PMID: 9726688 DOI: 10.1080/00016489850154775] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Twelve cases with membranous basal cell adenoma of the salivary gland were analysed clinicopathologically. Its histology was characterized by palisading of peripheral cells and an excessive hyaline basal membrane. The differential diagnosis involved the solid variant of basal cell adenoma, basal cell adenocarcinoma, solid subtype of adenoid cystic carcinoma and basaloid squamous cell carcinoma. Four cases had coexisting dermal cylindromas of the scalp. Screening for skin lesions of the scalp or other locations is suggested. In 8 cases, the tumors demonstrated multifocal origin. Total parotidectomy rather than superficial parotidectomy is suggested to avoid the recurrence of the tumor. One case showed malignant transformation and cervical lymph node metastases. A close follow-up after treatment is necessary.
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Affiliation(s)
- G Y Yu
- Department of Oral and Maxillofacial Surgery, Beijing Medical University, China.
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253
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Morice WG, Ferreiro JA. Distinction of basaloid squamous cell carcinoma from adenoid cystic and small cell undifferentiated carcinoma by immunohistochemistry. Hum Pathol 1998; 29:609-12. [PMID: 9635682 DOI: 10.1016/s0046-8177(98)80011-7] [Citation(s) in RCA: 117] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Basaloid squamous cell carcinoma (BSCC) is a recently recognized variant of squamous cell carcinoma (SCC) with a predilection to occur in the tongue base, hypopharynx, and supraglottic larynx. In smal biopsy specimens, these tumors can be difficult to distinguish from small cell undifferentiated carcinoma (SCUC) and adenoid cystic carcinoma (ACC). Monoclonal antibodies reactive with cytokeratin (AE1/AE3, 34betaE12, Cam 5.2) as well as a variety of other cellular antigens (vimentin, actin, desmin, chromogranin, synaptophysin, CD57, neuron-specific enolase [NSE], and S100) were used in an immunoperoxidase method with paraffin-embedded tissue to phenotypically characterize 23 cases of BSCC, 10 cases of SCUC, and 15 cases of ACC. The neoplastic cells in 22 of the 23 cases of BSCC reacted with the high-molecular-weight cytokeratin antibody 34betaE12, whereas no reactivity was seen in any of the 10 cases of SCUC. This pattern of 34betaE12 reactivity more consistently differentiated BSCC from SCUC than did reactivity with the neuroendocrine markers chromogranin, synaptophysin, CD57, and NSE. These findings show that immunoperoxidase stains performed on paraffin-embedded tissue are potentially useful in establishing a diagnosis of basaloid squamous cell carcinoma.
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MESH Headings
- Aged
- Aged, 80 and over
- Antibodies, Neoplasm/analysis
- Biomarkers, Tumor
- Carcinoma, Adenoid Cystic/chemistry
- Carcinoma, Adenoid Cystic/pathology
- Carcinoma, Basosquamous/chemistry
- Carcinoma, Basosquamous/pathology
- Carcinoma, Small Cell/chemistry
- Carcinoma, Small Cell/pathology
- Diagnosis, Differential
- Female
- Humans
- Immunohistochemistry
- Keratins/immunology
- Male
- Middle Aged
- Otorhinolaryngologic Neoplasms/chemistry
- Otorhinolaryngologic Neoplasms/pathology
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Affiliation(s)
- W G Morice
- Department of Laboratory Medicine and Pathology, Mayo Clinic and Foundation, Rochester, MN 55905, USA
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254
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Abiko Y, Muramatsu T, Tanaka Y, Ohuchi T, Satoh M, Okumura K, Shibata T, Inoue T, Kanazawa M, Arisue M, Shimono M, Kaku T. Basaloid-squamous cell carcinoma of the oral mucosa: report of two cases and study of the proliferative activity. Pathol Int 1998; 48:460-6. [PMID: 9702859 DOI: 10.1111/j.1440-1827.1998.tb03933.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Two cases of basaloid-squamous cell carcinoma (BSC) of the oral mucosa are described. The first case occurred at the floor of the mouth in a 58-year-old man, and the second case occurred at the mandibular gingiva in a 79-year-old woman. The laboratory data of the first case showed a positive response to hepatitis C virus antibody. In the first case, the tumor mass measured 4 x 4 cm in size, and was located at the lingual side of the median mandible beside the sublingual gland. In the second case, the tumor mass measured 25 x 15 mm in size, and was located in the alveolar mucosa of the right mandible. Histologically, both tumors showed a neoplastic epithelium arranged in a solid pattern with evidence of peripheral palisading, central necrosis, and some squamous differentiation. The proliferative activities of the BSC were compared with conventional squamous cell carcinomas (SCC) in the oral floor and gingiva, respectively, by employing a sensitive argyrophilic nuclear organizer region (AgNOR) staining method. The number of AgNOR per nucleus of the BSC was higher than that of any other SCC cases. The results support the opinion that BSC of the oral mucosa has a worse prognosis than conventional SCC.
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Affiliation(s)
- Y Abiko
- Department of Oral Pathology, School of Dentistry, Health Sciences University of Hokkaido, Ishikari-Tobetsu, Japan.
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255
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Hellquist H, Young-Wedenberg C. Reply. Oral Oncol 1998. [DOI: 10.1016/s1368-8375(97)00100-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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256
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Izumi K, Nakajima T, Maeda T, Cheng J, Saku T. Adenosquamous carcinoma of the tongue: report of a case with histochemical, immunohistochemical, and ultrastructural study and review of the literature. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 1998; 85:178-84. [PMID: 9503453 DOI: 10.1016/s1079-2104(98)90423-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
A rare case of oral adenosquamous carcinoma in a 78-year-old woman is reported. The tumor occurred in her tongue and metastasized to the submandibular and cervical lymph nodes. Histologically, the tumor showed invasive growth involving the submucosal and muscle layers. Its solid carcinomatous nests exhibited ductal differentiation in the deeper aspects and squamous differentiation toward the surface. Histochemical examination revealed an accumulation of acid mucopolysaccharide in the ductal lumina, and the ductal cells were immunohistochemically positive for carcinoembryonic antigen, epithelial membrane antigen, cancer antigen 15-3 and Ulex europaeus agglutinin I. Ultrastructurally, tonofibrils, desmosomes and numerous cytoplasmic processes were common features of the tumor cells. In addition, true glandular structures and pseudocysts were seen in areas. Clinical features of 13 adenosquamous carcinomas in the literature were analyzed.
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Affiliation(s)
- K Izumi
- First Department of Oral and Maxillofacial Surgery, Niigata University School of Dentistry, Japan
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257
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Ferlito A, Altavilla G, Rinaldo A, Doglioni C. Basaloid squamous cell carcinoma of the larynx and hypopharynx. Ann Otol Rhinol Laryngol 1997; 106:1024-35. [PMID: 9415598 DOI: 10.1177/000348949710601206] [Citation(s) in RCA: 77] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Basaloid squamous cell carcinoma (BSCC) is a recently described bimorphic variant of squamous cell carcinoma with distinct morphological and biological features. We describe the clinicopathological findings, along with immunohistochemical and ultrastructural investigations, in 15 new cases of BSCC of the larynx or hypopharynx observed and treated at the otolaryngology department of the University of Padua between 1989 and 1995. The world literature is also reviewed in order to develop a more accurate clinicopathological profile of the tumor. Patient records and histologic slides were reviewed in all of our 15 cases. The patient group consisted of 13 men (86.67%) and 2 women with a mean age of 63.33 years (median 69 years; range 44 to 84 years). Nine patients presented with cervical lymph node metastases. Surgical treatment was the therapy of choice; radiotherapy and chemotherapy have been applied in different combinations. Follow-up was available on all 15 cases. Local recurrence was described in 3 cases. Five of the 9 patients with cervical lymph node metastases developed distant metastases. Distant spread of the tumor without lymph node involvement was observed during follow-up in 4 cases. Nine patients died of disease, 2 are alive with widespread metastases, 2 are alive with no evidence of disease, and 2 have died of other causes. The determined 5-year survival was estimated to be 17.5% by the Kaplan-Meier method. In conclusion, BSCC is a distinctive carcinoma that is important to recognize, because it has a more aggressive biological behavior than conventional squamous cell carcinoma.
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Affiliation(s)
- A Ferlito
- Department of Otolaryngology, University of Padua, Italy
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258
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Khurana KK, Powers CN. Basaloid squamous carcinoma metastatic to renal-cell carcinoma: fine-needle aspiration cytology of tumor-to-tumor metastasis. Diagn Cytopathol 1997; 17:379-82. [PMID: 9360052 DOI: 10.1002/(sici)1097-0339(199711)17:5<379::aid-dc12>3.0.co;2-k] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
We describe an unusual case of a basaloid squamous-cell carcinoma (BSCC) of the tonsil in a 56-yr-old man that metastasized to a primary renal-cell carcinoma (RCC) and the lung. The diagnosis of the second primary, the RCC, was based on fine-needle aspiration (FNA) cytology. A subsequent nephrectomy specimen revealed BSCC metastatic to RCC, clear-cell type. Retrospective analysis of the FNA of the renal mass revealed classic RCC morphology and, in addition, another cytologically distinctive pattern characterized by occasional sheets of cohesive neoplastic cells with hyperchromatic nuclei and nuclear molding representative of BSCC. The cytologic features of a subsequent FNA of the lung were characteristic of metastatic BSCC. Our retrospective analysis of cytologic material from the renal mass underscores the importance of raising the possibility of tumor-to-tumor metastasis when distinctly different morphologic features are seen in an otherwise typical cytology of a neoplasm in patients with an already known or suspected second primary. To our knowledge, this case report is the first one documenting metastasis of BSCC to RCC.
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Affiliation(s)
- K K Khurana
- Department of Pathology, State University of New York Health Science Center, University Hospital, Syracuse 13210, USA
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259
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Sato M, Horiuchi M, Ogata T, Yamazaki M, Sakai M, Kato Y, Shimamura K. Basaloid squamous carcinoma of the larynx: report of a case. Auris Nasus Larynx 1997; 24:417-22. [PMID: 9352836 DOI: 10.1016/s0385-8146(97)10005-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Basaloid squamous carcinoma (BSC) is a rare neoplasm. We present a case of basaloid squamous carcinoma of the larynx in a 57-year-old male patient. The diagnosis before treatment was supraglottic carcinoma (T3N1MO) and biopsy of the larynx revealed a poorly differentiated squamous cell carcinoma. Total laryngectomy and right radical neck dissection were performed, and pathological studies of a specimen removed from the larynx revealed BSC of the larynx. The patient's postoperative progress was uneventful, however, 12 months later he developed lung metastasis of the left side. The patient underwent partial resection of the lung. He developed recurrence of lung metastasis 6 months later. Chemotherapy with cisplatin (CDDP) and vindesine sulfate (VSD) was administered in two courses, but the efficacy was evaluated as no change (NC). At present, 26 months after the first visit, he has been asymptomatic with lung metastasis, and there was no evidence of recurrence in the neck.
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Affiliation(s)
- M Sato
- Department of Otorhinolaryngology, Tokai University Tokyo Hospital, Japan
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260
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Abiko Y, Okumura K, Ohuchi T, Konishi T, Kanazawa M, Kaku T. Basaloid-squamous cell carcinoma of the floor of the mouth: characterization of a cell line. J Oral Pathol Med 1997; 26:367-70. [PMID: 9379426 DOI: 10.1111/j.1600-0714.1997.tb00232.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Since it was first described in 1986, basaloid-squamous cell carcinoma (BSC) has been considered a distinct variant of squamous cell carcinoma that occurs in a variety of anatomic sites, including the head and neck region. We report the characterization of the first cell line established from a basaloid-squamous cell carcinoma of the floor of the mouth. The cell line exhibited a highly invasive capacity, indicating that BSC has very aggressive behavior. This cell line may be a useful model for elucidation of the biological characteristics of BSC.
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Affiliation(s)
- Y Abiko
- Department of Oral Pathology, School of Dentistry, Health Sciences University of Hokkaido, Japan
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261
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Singhal SK, Panda NK, Mann SB, Dass A. Basaloid squamous cell carcinoma - larynx. Indian J Otolaryngol Head Neck Surg 1997; 49:265-8. [PMID: 23119306 DOI: 10.1007/bf02991288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Basaloid squamous cell carcinoma is a rare variant of squamous cell carcinoma, Larynx has been an uncommon site of this tumour which is said to have aggressive biological behaviour with high incidence of cervical and distant metastasis along with second primary. Two cases of laryngeal basaloid squamous cell carcinoma are reported with relevant review of literature. The submucosal spread of tumour is highlighted alongwith role of preoperative radio therapy.
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Affiliation(s)
- S K Singhal
- Department of Otolaryngology Head & Neck Surgery and Histopathology, Post Graduate Institute of Medical Education and Research, 160012 Chandigarh, India
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262
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Strassburger S, Hyckel P, Schumann D, Berndt A, Kosmehl H. [Basaloid squamous epithelial carcinoma (basaloid-squamous carcinoma) of the mouth floor. Differential diagnosis and response to neoadjuvant chemotherapy]. MUND-, KIEFER- UND GESICHTSCHIRURGIE : MKG 1997; 1:239-43. [PMID: 9410634 DOI: 10.1007/bf03043557] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The basaloid squamous cell carcinoma (BSCC) is a variant of squamous cell carcinoma, having histologically distinctive features and appearing in the oral cavity, upper respiratory tract and esophagus. Histological hallmarks are the presence of a basaloid component in intimate association with squamous cell carcinoma. The basaloid component is characterized by tightly packed nests of cells with scant cytoplasm and hyperchromic nuclei without visible nucleoli and an increased mitosis rate. Basaloid squamous cell carcinoma is said to have a higher malignant potential than common oral squamous cell carcinoma with an increased incidence of regional lymph-node metastases and distant metastases. Our finding of a Ki-67 index of 30% and the immunohistochemical demonstration of p53 protein speaks well for enhanced aggressive biological behavior. The differential diagnosis includes the adenoid cystic, mucoepidermoid, neuroendocrine, adenosquamous and conventional oral squamous cell carcinoma. Because of early dissemination, radical surgical treatment and additional radiation therapy are considered necessary. Our findings indicate that partial clinical and histological tumor regression occurs after systemic neoadjuvant chemotherapy.
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Affiliation(s)
- S Strassburger
- Klinik für Mund-, Kiefer- und Gesichtschirurgiel Plastische Operationen, Friedrich-Schiller-Universität, Jena
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263
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Sarbia M, Verreet P, Bittinger F, Dutkowski P, Heep H, Willers R, Gabbert HE. Basaloid squamous cell carcinoma of the esophagus: diagnosis and prognosis. Cancer 1997; 79:1871-8. [PMID: 9149011 DOI: 10.1002/(sici)1097-0142(19970515)79:10<1871::aid-cncr5>3.0.co;2-j] [Citation(s) in RCA: 90] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Basaloid squamous cell carcinoma (BSCC) is a recently recognized, poorly differentiated variant of squamous cell carcinoma (SCC), which is located predominantly in the upper aerodigestive tract. METHODS In this study, clinical and pathologic parameters of 17 BSCCs and 133 typical SCCs of the esophagus that underwent potentially curative resection (no distant metastases, no residual tumor) were compared. In addition, light microscopic, electron microscopic, and immunohistochemical features of BSCC were investigated, to determine whether this type of carcinoma could be differentiated from other poorly differentiated carcinomas of the esophagus. RESULTS Light microscopic study showed that BSCC was composed of relatively small tumor cells, arranged in solid lobules with abundant comedo-type necrosis. BSCC was almost invariably accompanied by areas of concomitant typical SCC, foci of squamous cell differentiation, and/or severe squamous cell dysplasia or carcinoma in situ of the adjacent mucosa. Ultrastructurally, BSCC inconsistently showed features of squamous cell differentiation. Immunohistochemically, BSCC displayed poor reactivity for antibodies against wide-range cytokeratins and cytokeratin subtypes that are typical of squamous cell epithelia (cytokeratin 13 and cytokeratin 14). Infrequently, expression of Leu7, smooth muscle actin, and S-100 protein was found. In comparison with typical SCC, the characteristic features of BSCC were older patient age, higher proliferative activity (MIB-1 labelling index), and higher apoptotic indices. No differences were found with regard to pT classification, pN classification, tumor size, blood vessel invasion, lymphatic vessel invasion, neural invasion, or patient gender. Moreover, no differences in overall survival rates were found. CONCLUSIONS BSCC is a distinct histopathologic variant of SCC, characterized by a poor degree of differentiation and high proliferative activity. However, after potentially curative resection, the prognosis of patients with BSCC of the esophagus does not differ from that of patients with typical SCC.
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MESH Headings
- Actins/analysis
- Adult
- Age Factors
- Aged
- Aged, 80 and over
- Antigens, Differentiation/analysis
- Apoptosis
- Carcinoma in Situ/pathology
- Carcinoma, Basosquamous/diagnosis
- Carcinoma, Basosquamous/pathology
- Carcinoma, Basosquamous/surgery
- Carcinoma, Squamous Cell/diagnosis
- Carcinoma, Squamous Cell/pathology
- Carcinoma, Squamous Cell/surgery
- Cell Differentiation
- Cell Division
- Diagnosis, Differential
- Epithelium/pathology
- Esophageal Neoplasms/diagnosis
- Esophageal Neoplasms/pathology
- Esophageal Neoplasms/surgery
- Female
- Humans
- Immunohistochemistry
- Keratins/analysis
- Male
- Microscopy, Electron
- Middle Aged
- Mucous Membrane/pathology
- Necrosis
- Neoplasm Invasiveness
- Neoplasm Staging
- Prognosis
- S100 Proteins/analysis
- Sex Factors
- Survival Rate
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Affiliation(s)
- M Sarbia
- Department of Pathology, Heinrich Heine University, Düsseldorf, Germany
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264
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Grötz KA, Kuffner HD, Mitze M, Reichert T, Wagner W. [Basaloid squamous epithelial carcinoma of the mouth mucosa]. MUND-, KIEFER- UND GESICHTSCHIRURGIE : MKG 1997; 1:137-45. [PMID: 9410621 DOI: 10.1007/bf03043533] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The basaloid-squamous carcinoma (BSC) that was first described in 1986 by Wain et al. for the head and neck region is a rare distinct variant of squamous cell carcinoma (SCC). The cardinal histopathologic feature is a biphasic cellular pattern of basaloid and squamous components. BSC has been confused with solid adenoid cystic carcinoma (ACC). Although the number of reported cases is small, BSC appears biologically virulent, with a propensity to aggressive local behavior, early regional and distant metastasis, and subsequent poor survival. We report the clinicopathological characteristics of 4 new cases and compare their immunohistochemical features with those of solid ACC and conventional SCC. Our results show that BSC, ACC and SCC react to CK 5/6. SCC is CK 10- and CK 13-positive, while BSC and ACC are negative for these markers. BSC and ACC react to CK 8, but in ACC only the luminal cells are CK 8 positive: therefore ACC has a glandular pattern. Our findings indicate that the immunohistochemical differences between BSC and ACC can facilitate their differential diagnosis. Because the biologic behavior of BSC differs from ACC and SCC, distinction among these tumor types is warranted.
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Affiliation(s)
- K A Grötz
- Klinik für Mund-, Kiefer- und Gesichtschirurgie, Johannes-Gutenberg-Universität, Mainz
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265
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Cappellai JO. Histopathology And Pathologic Prognostic Indicators Of Laryngeal Cancer. Otolaryngol Clin North Am 1997. [DOI: 10.1016/s0030-6665(20)30244-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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266
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Mooney EE, Dodd LG, Vollmer RT, Bossen EH. Fine-needle aspiration biopsy diagnosis of primary bronchial basaloid-squamous carcinoma. Diagn Cytopathol 1997; 16:187-8. [PMID: 9067117 DOI: 10.1002/(sici)1097-0339(199702)16:2<187::aid-dc21>3.0.co;2-h] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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267
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Ferlito A, Devaney KO, Rinaldo A. Squamous neoplastic component in unconventional squamous cell carcinomas of the larynx. Ann Otol Rhinol Laryngol 1996; 105:926-32. [PMID: 8916871 DOI: 10.1177/000348949610501115] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Both otolaryngologists and surgical pathologists are involved in the diagnosis and treatment of lesions of the larynx that are best diagnosed as invasive squamous cell carcinomas of some specified degree of differentiation, not further subclassified (that is, conventional squamous cell carcinomas). On occasion, however, a patient will present with an invasive tumor that on histologic examination diverges from the expected pattern of a squamous cell carcinoma of the usual type and so raises the question of proper classification (on the part of the pathologist) and, following classification, a consideration of the prognostic and therapeutic implications of such a classification (on the part of the clinician). While some of these unconventional squamous cell carcinomas are rather indolent lesions (as, for example, the hybrid verrucous squamous cell carcinoma), others behave in a fashion similar to conventional squamous cell carcinomas (such as the adenoid squamous cell carcinomas), and yet others seem to behave more aggressively than do conventional squamous cell carcinomas of a similar size and stage (examples include the basaloid squamous cell carcinomas and adenosquamous carcinomas). Finally, the possibility exists within the larynx, as elsewhere in the body, that a nonepithelial lesion such as malignant melanoma may mimic a tumor more commonly encountered in that vicinity- namely, a squamous cell carcinoma- and so receive inappropriate treatment if such mimicry is not recognized.
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Affiliation(s)
- A Ferlito
- Department of Otolaryngology, University of Padua, Italy
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268
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269
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Abe K, Sasano H, Itakura Y, Nishihira T, Mori S, Nagura H. Basaloid-squamous carcinoma of the esophagus. A clinicopathologic, DNA ploidy, and immunohistochemical study of seven cases. Am J Surg Pathol 1996; 20:453-61. [PMID: 8604812 DOI: 10.1097/00000478-199604000-00008] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Basaloid-squamous carcinoma (BSC) of the esophagus is a rare but interesting neoplasm that occurs primarily in the upper aerodigestive tract. In this study, we reviewed 371 cases of esophageal malignancies and detected seven cases (1.9%) of BSC. The clinicopathologic features, light and electron microscopic findings, and immunohistochemical localization of various differentiation-related antigens, including cytokeratin (CK) subtypes, p53, and epidermal growth factor receptor (EGFR), were examined. DNA ploidy was also determined in an effort to characterize the biologic features of these tumors. The tumors were classified as stage I (n = 1), IIB (n = 3), III (n = 2) or IV (n = 1). Six patients had lymph node metastasis, in four the metastatic carcinoma exhibited basaloid components. Histologically, all the tumors displayed a biphasic pattern of basaloid and squamous components. The former predominated in three cases, the latter in four cases. All the tumors contained solid growth of basaloid cells with microcystic patterns and stromal hyalinosis as well as palisading of cells. Ultrastructurally, markedly replicated basement membrane was observed. Immunohistochemistry revealed staining with only CK 14 and CK 19 antibodies in the periphery of the basaloid tumor nests. These antibodies were also positive in the basal layer of normal esophagus. Diffuse immunoreactivity for EGFR was demonstrated in all the tumors. Five tumors displayed p53 nuclear immunoreactivity. All of the basaloid components demonstrated aneuploidy by DNA image cytometry. We conclude that BSC is a distinct type of esophageal carcinoma that should be differentiated from the usual types of esophageal carcinoma and may be associated with aggressive biologic behavior.
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Affiliation(s)
- K Abe
- Department of Pathology, Tohoku University School of Medicine, Sendai, Japan
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270
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Abstract
An unusual case of polypoid carcinoma in a 72-year-old woman is reported. The tumor showed a pedunculated growth on the lateral border of the tongue and was composed of a malignant basaloid component in intimate association with definable foci of epithelial dysplasia of the surface mucosa. It was considered that histologic features of the present case corresponded with those of basaloid squamous carcinoma.
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Affiliation(s)
- F Ide
- Department of Oral Surgery, Saitama Medical Center, Kawagoe, Japan
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271
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Barnes L, Ferlito A, Altavilla G, MacMillan C, Rinaldo A, Doglioni C. Basaloid squamous cell carcinoma of the head and neck: clinicopathological features and differential diagnosis. Ann Otol Rhinol Laryngol 1996; 105:75-82. [PMID: 8546432 DOI: 10.1177/000348949610500115] [Citation(s) in RCA: 89] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Basaloid squamous cell carcinoma is a recently recognized variant of squamous cell carcinoma. The lesion is histologically distinctive and manifests a predilection for the supraglottis, pyriform sinus, and tongue base. The immunohistochemical profile is discussed. The differential diagnoses include adenoid cystic carcinoma, small cell neuroendocrine carcinoma, basal cell adenocarcinoma, adenosquamous carcinoma, squamous cell carcinoma, spindle cell squamous carcinoma, mucoepidermoid carcinoma, and adenoid squamous cell carcinoma. Basaloid squamous cell carcinoma is a biologically high-grade tumor with a propensity for nodal as well as systemic metastases. It is a morphologic and phenotypic entity with a separate prognostic significance.
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Affiliation(s)
- L Barnes
- Division of Head and Neck Pathology, Presbyterian-University Hospital, Pittsburgh, Pennsylvania, USA
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272
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Coppola D, Catalano E, Nicosia RF, Barnes L. Expression of TGF-Alpha and c-fos in Conventional and Basaloid Squamous Cell Carcinoma of Floor of Mouth. Int J Surg Pathol 1996. [DOI: 10.1177/106689699500300304] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Basaloid squamous cell carcinoma of the floor of the mouth is a newly recognized variant of squamous cell carcinoma that has a very aggressive behavior. To characterize basaloid squamous cell carcinoma at the molecular level, the authors studied the immunohistochemical expression in this tumor of the oncogene c-fos and of transforming growth factor-alpha. Eight cases of basaloid squamous cell carcinoma were evaluated by immunoperoxidase staining and compared to 16 squamous cell carcinomas of the floor of the mouth that ranged from well to poorly differentiated. The expression of c-fos was stronger in basaloid squamous cell carcinoma and poorly differentiated squamous cell carcinoma than it was in well-differentiated squamous cell carcinoma. Conversely, transforming growth factor-alpha expression was much stronger in well-differentiated squamous cell carcinoma than in basaloid squamous cell carcinoma or poorly differentiated squamous cell carcinoma. Moderately differentiated squamous cell carcinomas showed weak to moderate immunostaining for transforming growth factor-alpha but stained intensely for c- fos, which was consistently expressed at a high level in these tumors. This study confirms the poorly differentiated nature of basaloid squamous cell carcinoma, which has a similar pattern of staining as poorly differentiated. The decreased expression of transforming growth factor-alpha in basaloid squamous cell carcinoma may be related to the low degree of differentiation of this tumor since transforming growth factor-alpha tends to have higher levels of expression in well-differentiated tumor cells. Int J Surg Pathol 3(3):169-174, 1996
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Affiliation(s)
- Domenico Coppola
- Department of Pathology, UPMC-Montefiore University Hospital, Pittsburgh, Pennsylvania
| | - Edison Catalano
- Department of Pathology, Cooper Hospital University Medical Center, Camden, New Jersey
| | - Roberto F. Nicosia
- Department of Pathology, Medical College of Pennsylvania, Philadelphia, Pennsylvania
| | - Leon Barnes
- Department of Pathology, UPMC-Montefiore University Hospital, Pittsburgh, Pennsylvania
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273
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Akyol MU, Seçkin S, Akbayrak L, Ozdem C. Basaloid squamous cell carcinoma of the larynx. Eur Arch Otorhinolaryngol 1995; 252:485-7. [PMID: 8719591 DOI: 10.1007/bf02114756] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Basaloid squamous cell carcinoma is a variant of squamous cell carcinoma that was first described in 1986. In the English-language literature, only 26 cases of this infrequent histopathological entity have been reported in the larynx. Tumors have an aggressive biological behavior, justifying combined surgical treatment with radiotherapy. Two new cases are presented and the literature reviewed.
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Affiliation(s)
- M U Akyol
- Department of Otolaryngology, Numune Hospital, Ankara, Turkey
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274
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Wan SK, Chan JK, Lau WH, Yip TT. Basaloid-squamous carcinoma of the nasopharynx. An Epstein-Barr virus-associated neoplasm compared with morphologically identical tumors occurring in other sites. Cancer 1995; 76:1689-93. [PMID: 8625035 DOI: 10.1002/1097-0142(19951115)76:10<1689::aid-cncr2820761003>3.0.co;2-9] [Citation(s) in RCA: 47] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Basaloid-squamous carcinoma is a newly characterized, highly aggressive neoplasm occurring mostly in the base of tongue, hypopharynx, larynx, and esophagus. Its occurrence in the nasopharynx is rare. METHODS The clinicopathologic features of three cases of basaloid-squamous carcinoma of the nasopharynx are described and were studied for the presence of Epstein-Barr virus (EBV) by in situ hybridization for EBV-encoded small nuclear RNA (EBER). For comparison, basaloid-squamous carcinomas occurring in other sites also were studied for the presence of EBV. RESULTS EBER was detected in all 3 cases of basaloid-squamous carcinoma occurring in the nasopharynx, but in none of the 13 cases from other sites including the esophagus, larynx, pharynx, hypopharynx, and nasal cavity. The nasopharyngeal basaloid-squamous carcinomas occurred in two male and one female patients with an age range of 48-70 years. The serum immunoglobulin A against the EBV-viral capsid antigen was elevated in all three cases. Two patients developed cervical lymph node involvement during the course of the disease. All three patients were treated by radiotherapy and survived for longer than 34 months compared with the average reported median survival of approximately 2 years for basaloid-squamous carcinomas occurring in the usual sites. CONCLUSION Based on this limited study, basaloid-squamous carcinoma occurring in the nasopharynx appears to be an EBV-associated neoplasm, whereas the same tumor occurring in other sites is not. The prognosis is potentially better for patients with nasopharyngeal basaloid-squamous carcinoma, which appears to be pathogenetically and biologically more related to the much more common nasopharyngeal undifferentiated carcinoma.
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Affiliation(s)
- S K Wan
- Department of Pathology and Radiotherapy, Queen Elizabeth Hospital, Hong Kong
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275
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Affiliation(s)
- S J Miller
- Dermatology Department, Johns Hopkins University, Baltimore, Maryland 21287-0900, USA
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276
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Hewan-Lowe K, Dardick I. Ultrastructural distinction of basaloid-squamous carcinoma and adenoid cystic carcinoma. Ultrastruct Pathol 1995; 19:371-81. [PMID: 7483013 DOI: 10.3109/01913129509021909] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Basaloid-squamous carcinoma is a unique and infrequent variant of squamous cell carcinoma with a predilection for occurring in the upper aerodigestive tract. The cardinal diagnostic criteria are the presence of basaloid cells arranged in lobules or cords and a squamous component. Another feature that distinguishes basaloid-squamous carcinoma from conventional squamous cell carcinoma is the development of multiple foci of amorphous, eosinophilic, or mucinous materials among the basaloid tumor cells. It is this feature in basaloid-squamous carcinoma that causes confusion with adenoid cystic carcinoma, especially the solid variant of adenoid cystic carcinoma. To clarify the distinctive features of these two types of tumors, the ultrastructural findings in three basaloid-squamous carcinomas from the head and neck region were compared with three adenoid cystic carcinomas, one from the head and neck region and one each from trachea and bronchus. Widened intercellular spaces, tonofilaments, and replicated basal lamina were present in both types of tumor. However, the ultrastructural features of glandular differentiation were present only in adenoid cystic carcinoma, whereas the ultrastructural features of squamous cell differentiation were present only in basaloid-squamous carcinoma. The distinction between basaloid-squamous carcinoma and adenoid cystic carcinoma is important since basaloid-squamous carcinoma is a clinically aggressive, high-grade form of squamous cell carcinoma, generally with a worse prognosis than adenoid cystic carcinoma.
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Affiliation(s)
- K Hewan-Lowe
- Department of Pathology, Emory University, Atlanta, Georgia, USA
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277
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Napier SS, Gormely JS, Newlands C, Ramsay-Baggs P. Adenosquamous carcinoma. A rare neoplasm with an aggressive course. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 1995; 79:607-11. [PMID: 7600225 DOI: 10.1016/s1079-2104(05)80103-9] [Citation(s) in RCA: 47] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
We report a case of adenosquamous carcinoma that arose in the maxillary alveolus of a 61-year-old woman, metastasized rapidly to submandibular and deep cervical lymph nodes, and caused death in spite of surgery and radiotherapy. Our case highlights the aggressive behavior associated with this tumor when it occurs in the oral cavity and at most other body sites. In addition, the oral adenosquamous carcinoma may not be as rare as the small number of reported cases might suggest because the adenocarcinoma component may form a very small proportion of the tumor as in our case, and the histopathologic criteria for diagnosis are not clearly established. Thus some cases of adenosquamous carcinoma may not be recognized as such. This underlines the important role of the histopathologist in the diagnosis of oral cancer by the recognition of specific subtypes of cancer and their associated prognostic significance.
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Affiliation(s)
- S S Napier
- School of Clinical Dentistry, Queen's University and Ulster, Belfast, UK
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278
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van der Wal JE, Snow GB, Karim AB, van der Waal I. Adenoid cystic carcinoma of the palate with squamous metaplasia or basaloid-squamous carcinoma? Report of a case. J Oral Pathol Med 1994; 23:461-4. [PMID: 7861331 DOI: 10.1111/j.1600-0714.1994.tb00445.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- J E van der Wal
- Department of Oral & Maxillofacial Surgery, Free University Hospital, Amsterdam, The Netherlands
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279
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Affiliation(s)
- H B Hellquist
- Department of Pathology, Medical Center Hospital, Orebro, Sweden
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280
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Abstract
BACKGROUND Basal cell carcinomas (BCCs) have been described in various locations, such as skin, anal canal, tongue, larynx, and recently, the lungs. These tumors seem to have a poor prognosis. METHODS A series of 115 surgically resected lung tumors, previously classified as poorly or undifferentiated carcinoma, were reviewed retrospectively. From these, 37 cases were reclassified as BCCs and were compared in terms of clinical features and survival, with 40 cases reclassified as poorly differentiated squamous cell (PDSC) carcinoma of the lung. RESULTS There was no difference between the groups regarding age, clinical presentation, pattern of relapse, and cause of death. Median and overall survival were different between the two groups, especially for Stage I and II patients: 5-year actuarial survival in the BCC group was 15% and in the PDSC group 47% (P = 0.004). CONCLUSIONS This subset of non-small cell lung cancer (NSCLC) has a worse prognosis than other NSCLC, and this should be considered in survival studies and new treatment trials.
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Affiliation(s)
- D Moro
- Department of Respiratory Medicine, Hopital A. Michallon, Grenoble, France
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281
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Ishikawa Y, Asuwa N, Ishii T, Masuda S, Kiguchi H. A case of basaloid-squamous carcinoma of the esophagus: immunohistochemical and ultrastructural studies. Pathol Int 1994; 44:466-74. [PMID: 8055114 DOI: 10.1111/j.1440-1827.1994.tb01712.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
A case of basaloid-squamous carcinoma of the esophagus in an 83 year old man is reported. The esophageal tumor showed a fungating growth at the junction of the middle and lower esophagus and was composed microscopically of submucosal multiple nests with solid and cribriform-like patterns accompanied with a small focus of squamous cell carcinoma adjacent to the overlying esophageal epithelium. The structural features closely resembled those of basaloid-squamous carcinoma. The submucosal tumor cells were immunohistochemically positive for epithelial membrane antigen, wide spectral keratin, alpha actin and S-100 protein. By electron microscopy, the tumor cells had microvilli, desmosomes and bundles of myofilaments, and replicated basement membranes were frequently observed adjacent to the nests. The positive immunoreaction of S-100 protein and alpha actin and the existence of bundles of myofilaments indicated that the present tumor did not correspond well with basaloid-squamous carcinoma. In addition, there was no evidence of true glandular lumina in the tumor nests, a finding which was inconsistent with that of adenoid cystic carcinoma. From the immunoreactivity of S-100 protein and ultrastructural features, it was considered that the present submucosal tumor had originated from undifferentiated pluripotential primitive cells, which differentiated to myoepithelial cells.
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Affiliation(s)
- Y Ishikawa
- Department of Pathology, Hachioji Medical Center, Tokyo Medical College, Japan
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282
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Raslan WF, Barnes L, Krause JR, Contis L, Killeen R, Kapadia SB. Basaloid squamous cell carcinoma of the head and neck: a clinicopathologic and flow cytometric study of 10 new cases with review of the English literature. Am J Otolaryngol 1994; 15:204-11. [PMID: 8024109 DOI: 10.1016/0196-0709(94)90006-x] [Citation(s) in RCA: 85] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
INTRODUCTION We describe the clinicopathologic and flow cytometric features of 10 cases of basaloid squamous cell carcinoma (BSCC) of the head and neck to determine if DNA ploidy is a useful prognostic indicator. We also provide a review of 80 cases previously reported in the English language literature. MATERIALS AND METHODS The 10 cases were obtained from the surgical pathology files of Presbyterian University Hospital and The Eye and Ear Institute, Pittsburgh, PA (1987-1991). In all 10 cases, the microscopic slides and clinical data were reviewed. Flow cytometry was performed using the Hedley technique and formalin-fixed, paraffin-embedded tissue. RESULTS The mean age of patients with BSCC was 64 years (range, 49 to 75 years). Tumor involved the base of tongue (n = 5), hypopharynx-epiglottis (n = 3), and tonsil (n = 1). One case presented with cervical lymph node metastasis from an unknown primary site. Histologically, BSCC showed a biphasic pattern with basaloid-squamous elements, comedonecrosis, stromal hyalinization, surface dysplasia, and an in situ and/or invasive squamous cell carcinoma component. Flow cytometry revealed six diploid and four aneuploid tumors. Five of six patients with diploid and all four patients with aneuploid tumors developed early regional and/or distant metastases. Of the two patients who died of disease, one had a diploid and the other an aneuploid tumor. CONCLUSION Our study reaffirms the predilection of BSCC for the base of tongue, pyriform sinus, and supraglottic larynx, and its aggressive biologic behavior with a high incidence of cervical lymph node metastasis (64%), distant spread (44%), and death from disease (38% mortality at 17 months median follow-up). However, in contrast to previous reports, tumor ploidy by flow cytometry provided no additional prognostic information beyond that supplied by routine histologic evaluation.
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Affiliation(s)
- W F Raslan
- Department of Pathology, Presbyterian University Hospital, Pittsburgh, PA 15213
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283
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Ereño C, Lopez JI, Sanchez JM, Toledo JD. Basaloid-squamous cell carcinoma of the larynx and hypopharynx. A clinicopathologic study of 7 cases. Pathol Res Pract 1994; 190:186-93. [PMID: 8058572 DOI: 10.1016/s0344-0338(11)80710-7] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
During a 16-year period (1974-1989), a retrospective review of 468 surgical specimens of laryngectomy yielded 7 cases (0.66%) of basaloid-squamous cell carcinoma. They were all males between 42 and 63 years of age. Four cases were supraglottic and one transglottic. The other two arose in the left pyriform sinus and vallecula, respectively. At diagnostic time, 4 cases were Stage III and 2 Stage IV, only one being Stage II. Glanz index of histologic malignancy was high (> 5) in most cases (6/7). Mitotic rate was also high (22-78 mitoses/10 HPF). Lymph node metastases were documented at diagnosis in 5 cases, 3 of them presenting with extracapsular extension. One case developed liver metastases. During the follow-up, lymph nodes of the neck were again metastasized in 4 cases, and stomal recurrence was present in another one. Death of disease was confirmed in 5 cases after 10 to 35 months of follow-up. Overall survival was 28.5% after 3 years.
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Affiliation(s)
- C Ereño
- Department of Pathology, Hospital de Basurto, Faculty of Medicine, Basque Country University (UPV/EHU), Bilbao, Spain
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284
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Abstract
BACKGROUND Only five cases of basaloid squamous cell carcinoma (BSCC), a rare tumor of head and neck, have been reported to involve the floor of mouth. METHODS Clinicopathologic and immunohistochemical features of eight BSCC of floor of mouth were studied to evaluate the significance of the basaloid features. RESULTS Five patients were male and three were female. Their mean age was 52 years (range, 39-59). At presentation, one patient was diagnosed with Stage II disease, four were diagnosed with Stage III disease, and three were diagnosed with Stage IV disease. Aside from typical squamous differentiation, each patient had a component of basaloid cells arranged in irregular nests, cords, or pseudoglandular spaces with a brisk mitotic rate, myxoid stroma, and marked tendency for perineural invasion. A panel of immunostains yielded the following results: keratin, +8/8; carcinoembryonic antigen, +3/8; and S-100, chromogranin, and neuron-specific enolase were negative. Mucin stains were negative in all cases. Ultrastructural characterization of three BSCC revealed squamous differentiation of the basaloid cells and a peculiar basal membrane-like material in between them. No neurosecretory granules were present. Seven patients underwent surgery; six of them were also treated with postoperative radiation therapy. In two cases, chemotherapy was added at recurrence. One nonresectable patient received radiation and chemotherapy. At the last follow-up, five patients were dead of disease within 13 months from the diagnosis. One patient died of an unknown cause. Two patients were still alive at the time of this report, 4 and 2 months after treatment. Seven patients had recurrent disease. The authors compared these data with a control group of patients with conventional squamous cell carcinoma (SCC). CONCLUSIONS The authors' results indicate that BSCC of floor of mouth is an aggressive variant of SCC and is prognostically worse than the conventional SCC, regardless of the grade of the latter.
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Affiliation(s)
- D Coppola
- Department of Pathology, Temple University Hospital and School of Medicine, Philadelphia, Pennsylvania
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285
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Ferlito A. The World Health Organization's revised classification of tumours of the larynx, hypopharynx, and trachea. Ann Otol Rhinol Laryngol 1993; 102:666-9. [PMID: 8373087 DOI: 10.1177/000348949310200903] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
A second edition of the Histological Typing of Upper Respiratory Tract Tumours in the WHO series International Histological Classification of Tumours was published in 1991. The new edition has been entitled Histological Typing of Tumours of the Upper Respiratory Tract and Ear. The task of revising the first edition, which was published in 1978, was undertaken at the WHO Center for Upper Respiratory Tract Tumours by K. Shanmugaratnam in collaboration with L. H. Sobin and pathologists in 8 countries. Several tumour types have been added to the classification, and some have been redefined in light of current knowledge. This presentation outlines the changes in the revised WHO classification as regards tumours of the larynx, hypopharynx, and trachea and discusses the grounds for said revisions.
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Affiliation(s)
- A Ferlito
- Department of Otolaryngology, University of Padua, Italy
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286
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Larner JM, Malcolm RH, Mills SE, Frierson HF, Banks ER, Levine PA. Radiotherapy for basaloid squamous cell carcinoma of the head and neck. Head Neck 1993; 15:249-52. [PMID: 8491589 DOI: 10.1002/hed.2880150314] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Basaloid squamous cell carcinoma (BSCC) of the head and neck is a recently described high-grade variant of squamous cell carcinoma. It is a biologically virulent neoplasm with a propensity for nodal, as well as systemic, metastases. Because of the limited number of published reports, we reviewed data from patients of the University of Virginia Health Sciences Center and identified 16 cases of BSCC. The intent of this study was to determine the role of radiotherapy in the treatment of BSCC and better define the clinical features of this entity. Radiotherapy alone, or in combination with surgery, resulted in excellent local control rates. Distant metastases, chiefly pulmonary, occurred in more than half of the patients.
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Affiliation(s)
- J M Larner
- Division of Therapeutic Radiology and Oncology, University of Virginia Health Sciences Center, Charlottesville 22908
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287
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de Araújo VC, Biazolla ER, Moraes NP, Furuse TA, Melhado RM. Basaloid squamous carcinoma of the oral cavity. Report of a case. ORAL SURGERY, ORAL MEDICINE, AND ORAL PATHOLOGY 1993; 75:622-5. [PMID: 7683784 DOI: 10.1016/0030-4220(93)90237-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
A case of basaloid squamous carcinoma that involves the posterior buccal mucosa is described. The major histopathologic feature is a carcinoma with a basaloid pattern in association with squamous differentiation. The basaloid cells exhibit large and vesicular nuclei and eosinophilic clear or vacuolated cytoplasm. Cells are distributed in cords, trabeculae, or lobules that occasionally show glandular arrangement. The majority of the tumor cells are positive for keratin and a large group of cells distributed in glandular arrangement are positive also for vimentin.
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Affiliation(s)
- V C de Araújo
- Department of Oral Pathology, School of Dentistry, University of São Paulo, Brazil
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288
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Cadier MA, Kelly SA, Parkhouse N, Brough MD. Basaloid squamous carcinoma of the buccal cavity. Head Neck 1992; 14:387-91. [PMID: 1399573 DOI: 10.1002/hed.2880140509] [Citation(s) in RCA: 28] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Basaloid-squamous carcinoma was first recognized as a separate pathologic entity in 1986. It has been described in the hypopharynx, larynx, base of tongue, and nasal cavity. We report the first case of this rare tumor occurring in the buccal cavity and review the atypical squamous cell carcinomas that occurred in these sites.
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Affiliation(s)
- M A Cadier
- Department of Plastic and Reconstructive Surgery, University College Hospital, London, England
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289
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Brambilla E, Moro D, Veale D, Brichon PY, Stoebner P, Paramelle B, Brambilla C. Basal cell (basaloid) carcinoma of the lung: a new morphologic and phenotypic entity with separate prognostic significance. Hum Pathol 1992; 23:993-1003. [PMID: 1381335 DOI: 10.1016/0046-8177(92)90260-a] [Citation(s) in RCA: 158] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
On review of 115 poorly or undifferentiated lung cancers from 671 lung tumors resected over a 7-year period, we have found 38 cases of basaloid carcinoma. The cardinal histopathologic features distinguishing this tumor from other non-small cell lung cancers are a lobular growth pattern of small cells with moderately hyperchromatic nuclei, with no prominent nucleoli, and with scant cytoplasm, a high mitotic rate, and peripheral palisading. Basaloid carcinoma was present in a pure form in 19 cases and the other 19 tumors were of a mixed, but prominent, basaloid type associated with squamous cell carcinoma, large cell carcinoma, or adenocarcinoma. The immunophenotype of basaloid cancers was close to that of basal bronchial epithelial cells, with a low level of expression of low molecular weight cytokeratins. Staining for neuroendocrine markers was infrequent and inconsistent. Ultrastructural study showed an absence of neurosecretory granules and the presence of some squamous and/or glandular differentiation. This morphologic and immunologic phenotype suggests that basaloid carcinoma is derived from a pluripotent reserve cell or a basal bronchial epithelial stem cell. This unique histologic form of lung tumor has a poor prognosis, with a median survival rate of 22 months for stage I and II disease. This justifies classification of basaloid carcinoma as a distinct form of lung cancer, separate from small cell lung carcinoma.
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Affiliation(s)
- E Brambilla
- Department of Pathology, CHRU de Grenoble, France
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290
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291
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292
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Abstract
Basaloid-squamous carcinoma is a recently characterized, aggressive tumour occurring in the hypopharynx, larynx and base of tongue. We report a unique case involving the nasal cavity of a patient with a history of radiation therapy for nasopharyngeal carcinoma, raising the possibility that basaloid-squamous carcinoma can be radiation-associated.
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Affiliation(s)
- S K Wan
- Institute of Pathology, Queen Elizabeth Hospital, Hong Kong
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293
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Abstract
Basaloid-squamous carcinoma is a rare, nonsquamous cell tumor presenting in the head and neck that has recently been described. The clinical and histopathologic features of basaloid-squamous carcinoma derived from the 12 reported cases in the literature, including our case resembling an arteriovenous malformation, are described. The important interaction of the operating surgeon with the surgical pathologist in guiding the extent of the resection is emphasized.
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Affiliation(s)
- H M Lovejoy
- Department of Otolaryngology, Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, NC 27103
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294
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Abstract
Basaloid squamous carcinoma is believed to be a histologically distinct variant of squamous cell carcinoma of the neck region with 11 cases reported. Two cases arising in the pyriform fossa and vallecula are reported, both of which were associated with second primary malignant tumors: esophageal small cell carcinoma and palatal squamous cell carcinoma, respectively. The authors suggest that basaloid squamous carcinoma may be associated with a high incidence of second primary tumors in the upper gastrointestinal tract or larynx.
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Affiliation(s)
- J D Seidman
- Department of Pathology, University of Maryland School of Medicine, Baltimore
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295
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Martinez-Madrigal F, Casiraghi O, Khattech A, Nasr-Khattech RB, Richard JM, Micheau C. Hypopharyngeal sebaceous carcinoma: a case report. Hum Pathol 1991; 22:929-31. [PMID: 1916753 DOI: 10.1016/0046-8177(91)90186-s] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
A hypopharyngeal squamous-cell carcinoma with sebaceous differentiation is reported. In the primary as well as the metastatic lymph nodes, the tumor showed basaloid, squamous, and sebaceous cells. In addition, immunostaining for S-100 protein and vimentin manifested scattered cells showing cytoplasmic processes suggesting myoepithelial cells. An exhaustive review of the literature revealed only one similar case previously reported. The probable origin from the minor salivary glands is discussed.
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296
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Tsang WY, Chan JK, Lee KC, Leung AK, Fu YT. Basaloid-squamous carcinoma of the upper aerodigestive tract and so-called adenoid cystic carcinoma of the oesophagus: the same tumour type? Histopathology 1991; 19:35-46. [PMID: 1717358 DOI: 10.1111/j.1365-2559.1991.tb00892.x] [Citation(s) in RCA: 92] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Basaloid-squamous carcinoma of the larynx, pharynx and base of tongue and the so-called adenoid cystic carcinoma of the oesophagus are rare but distinctive tumours associated with a grave prognosis. They occur most commonly in elderly males and present at an advanced stage. Our study of four such laryngeal tumours and five such oesophageal tumours shows that they are histologically and immunohistochemically identical, providing support for the idea that they are the same tumour type. They show a biphasic pattern in which basaloid tumour is intimately associated with a neoplastic squamous component which can be invasive or in situ. The basaloid component is in the form of invasive lobules with frequent comedo-necrosis and hyalinization. The constituent cells possess pale pleomorphic nuclei with frequent mitoses. Immunoreactivity for cytokeratin in the basaloid component is remarkable for its absence or weak and focal nature. Review of the literature shows that only a few cases of 'adenoid cystic carcinoma' of the oesophagus are bona fide examples of adenoid cystic carcinoma as it occurs in the salivary glands, while the others are identical to basaloid-squamous carcinoma of the upper aerodigestive tract. Their distinction is important because genuine adenoid cystic carcinoma is much less aggressive than basaloid-squamous carcinoma.
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Affiliation(s)
- W Y Tsang
- Institute of Pathology, Queen Elizabeth Hospital, Kowloon, Hong Kong
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297
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Letter to the Case. Pathol Res Pract 1991. [DOI: 10.1016/s0344-0338(11)80018-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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298
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Takubo K, Mafune K, Tanaka Y, Miyama T, Fujita K. Basaloid-squamous carcinoma of the esophagus with marked deposition of basement membrane substance. ACTA PATHOLOGICA JAPONICA 1991; 41:59-64. [PMID: 2031457 DOI: 10.1111/j.1440-1827.1991.tb03273.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
A 71-year-old Japanese man with basaloid-squamous carcinoma of the esophagus is reported. The carcinoma contained basaloid cells, a few small cornified foci, and a large amount of eosinophilic hyaline substance, which reacted positively upon periodic acid-Schiff, type IV collagen, and laminin staining. Ultrastructural examination revealed markedly replicated basement membranes (BM). The morphological findings suggested that this tumor secreted abundant BM substance. Small nests of cancer cells were attached to the dysplastic esophageal epithelium. The tumor cells exhibited negative staining for mucin, secretory component, lactoferrin, and carcinoembryonic antigen. These findings, as well as the observed keratinization and attachment between the carcinoma nests and mucosal epithelium, indicate that the tumor originated in the mucosal epithelium of the esophagus.
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Affiliation(s)
- K Takubo
- Department of Pathology, Saitama Cancer Center, Japan
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299
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Shvili Y, Talmi YP, Gal R, Kessler E, Kolkov Z, Zohar Y. Basaloid-squamous carcinoma of larynx metastatic to the skin of the nasal tip. J Craniomaxillofac Surg 1990; 18:322-4. [PMID: 2262555 DOI: 10.1016/s1010-5182(05)80541-4] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Basaloid-squamous carcinoma is a rare, highly malignant epithelial tumour with problematic histological characteristics and a poor prognosis. This unusual tumour has been described in the tongue, hypopharynx, and larynx. A unique case of basaloid-squamous carcinoma of the larynx metastatic to the skin of the nasal tip is presented. The literature regarding the histopathological and clinical aspects of basaloid-squamous carcinoma is reviewed.
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Affiliation(s)
- Y Shvili
- Department of Otolaryngology, Hasharon Hospital, Petah-Tiqva, Israel
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300
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Luna MA, el Naggar A, Parichatikanond P, Weber RS, Batsakis JG. Basaloid squamous carcinoma of the upper aerodigestive tract. Clinicopathologic and DNA flow cytometric analysis. Cancer 1990; 66:537-42. [PMID: 2364364 DOI: 10.1002/1097-0142(19900801)66:3<537::aid-cncr2820660322>3.0.co;2-j] [Citation(s) in RCA: 123] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
This report adds nine basaloid squamous carcinomas (BSC) of the upper aerodigestive tract to the 11 already recorded in the literature. It includes the first flow cytometric analysis of their DNA content and compares the clinical behavior of BSC with conventional squamous cell carcinoma (SCC). An uncommon variant of squamous carcinoma, BSC manifests a predilection for the hypopharynx and base of tongue of men in the sixth decade of life. Histologically, the carcinoma is characterized by a basaloid pattern often in an intimate association with focal squamous differentiation, comedonecrosis, and stromal hyalinization. It is an aggressive neoplasm: seven of the nine patients had metastases to cervical lymph nodes at time of initial surgery and three of the five deaths occurred within 24 months after primary surgery followed by radiotherapy. Its aggressiveness notwithstanding, the biologic course of BSC is similar to that of conventional SCC when clinical stage, site, and treatment are matched. Patients with aneuploid BSC had a better mean survival time (39.5 months) than those with diploid carcinomas (16.3 months). Surgery followed by radiotherapy appears to be the treatment of choice. Because of a high incidence of distant metastases, adjuvant chemotherapy may be warranted.
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Affiliation(s)
- M A Luna
- Department of Pathology, University of Texas, M.D. Anderson Cancer Center, Houston
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