Sphenoid sinus basaloid squamous cell carcinoma presenting as a sellar mass: report a case with review of the literature

Intracranial squamous papillary lesion

Intracranial lesions with squamous differentiation raise a diagnostic challenge, which can include benign or malignant, primary and metastatic lesions. Here is the case of a 49‐year‐old woman, in which intraoperative cytology helped the differential and final diagnosis.

Basaloid squamous cell carcinoma of the sinonasal tract with metastasis to the liver: a case report and literature review

Basaloid squamous cell carcinoma (BSCC) is a rare subtype of squamous cell carcinoma. To date, only 95 cases of sinonasal BSCC have been reported in the English-language literature, and they account for 5% of all cases of head and neck BSCC. We describe what we believe is only the second reported case of a sinonasal tract BSCC that metastasized to the liver. The patient was a 36-year-old woman who presented with right-sided nasal obstruction and a foul-smelling discharge. Clinical examination and imaging identified a large, lobulated, enhancing mass in the right nasal cavity. Following excision of the mass, the patient was scheduled for radiotherapy. However, before it could be administered, follow-up imaging detected a metastasis to the liver and lung, and the patient was switched to chemotherapy. Initially, she responded well clinically, but at 5 months postoperatively, a follow-up CT showed an increasing metastatic presence in the liver and bone. The patient died of her disease 1 year after surgery.

Basaloid squamous cell carcinoma of the maxilla

Basaloid squamous cell carcinoma (BSCC) is a distinctive aggressive variant of squamous cell carcinoma. We present a case of a 60-year-old man with tender swelling in the right cheek region for 6 months and continuous unilateral nasal discharge for 2 months. Extraoral examination revealed an ovoid, well-defined swelling from the right infraorbital rim to the angle of the mouth superoinferiorly and the right lateral wall of the nose to preauricular region anteroposteriorly. Intraorally, an ulceroproliferative growth from right upper gingivobuccal sulcus to mid palatine raphe with bicortical expansion was evident. CT revealed a hypodense mass obliterating the right maxillary sinus. Histopathology showed closely packed basaloid cells, with hyperchromatic palisading nuclei, arranged in a solid pattern with a lobular configuration. Prominent areas of comedo necrosis and keratin pearl formation were seen. These features suggested BSCC. The patient underwent surgical excision with adjuvant radiation but was lost to follow-up after 6 months of radiation therapy.

Basaloid squamous cell carcinoma in the nasal cavity treated with proton beam therapy concurrent with cisplatin: a case report

INTRODUCTION

Basaloid squamous cell carcinoma is a rare and aggressive variant of squamous cell carcinoma. Basaloid squamous cell carcinoma is mostly seen in the upper aerodigestive tract and has a propensity for lymph node spread and systemic metastases. Various treatment modalities have been reported, including surgical excision supplemented with radiotherapy/adjuvant chemotherapy. To the best of our knowledge, treatment of nasal basaloid squamous cell carcinoma with proton beam therapy and cisplatin has not been described in the literature.

CASE PRESENTATION

We report the case of a 56-year-old Japanese man with locally invasive basaloid squamous cell carcinoma in his right nasal cavity with invasion of the orbit, paranasal sinus, and buccal subcutaneous tissue. He underwent proton beam therapy concurrent with cisplatin. Acute and late side effects did not exceed grade 3. At 24-month follow up, he remains in complete remission.

CONCLUSION

Proton beam therapy concurrent with cisplatin may be one choice for locally invasive basaloid squamous cell carcinoma.

Skull invaders: when surgical pathology and neuropathology worlds collide

Skull and dura serve as effective barriers to penetration by most tumors, often preventing masses originating intracranially from extending into the contiguous bone and soft tissues, or those arising in head and neck regions from extending into the dura and brain tissue. We review our 15-year experience with extracranial tumors that had sufficiently invaded adjacent skull, dura, or brain from the "outside-in" to require a neurosurgeon to participate in the surgical resection and discuss our 40 cases in context with the literature. Sinonasal-origin tumors (n = 17) and cutaneous tumors (n = 10) were the most frequent skull-invaders. Most of the cutaneous tumor types were squamous cellcarcinomas (n = 9); diverse sinonasal-origin types included 4 squamous cell carcinomas, 4 adenoid cystic carcinomas, 2 sinonasal undifferentiated carcinomas, 2 sinonasal adenocarcinomas, and single examples each of sinonasal-origin hemangiopericytoma, solitary fibrous tumor, melanoma, mucocele, and teratocarcinoma. There were 9olfactory neuroblastomas, and middle ear-origin basal cell carcinoma,recurrent glomus jugulare, and orbital malignant hidradenoma were also seen. Unique tumors included a cutaneous cylindroma invasive of skull convexity occurring in familial cylindromatosis and a ganglioneuroma of the middle ear with massive bilateral skull base extension. Convexity dural spread, a seldom-reported pattern of dissemination, was seen in 1 olfactory neuroblastoma and 1 adenoid cystic carcinoma. The ability to show skull/dural invasion did not correlate with specific histopathologic features; even benign tumor types can show skull/dural penetration.