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Patel AM, Haleem A, Choudhry HS, Brody RM, Brant JA, Carey RM. Elective Neck Dissection in cT1-4 N0M0 Head and Neck Basaloid Carcinoma. Otolaryngol Head Neck Surg 2024. [PMID: 38613196 DOI: 10.1002/ohn.757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 02/21/2024] [Accepted: 03/15/2024] [Indexed: 04/14/2024]
Abstract
OBJECTIVE To investigate the survival benefit of elective neck dissection (END) over neck observation in surgically resected cT1-4 N0M0 head and neck basaloid carcinoma (HNBC). STUDY DESIGN Retrospective cohort study. SETTING The 2006 to 2017 hospital-based National Cancer Database. METHODS Patients with surgically resected cT1-4 N0M0 HNBC were selected. Linear, binary logistic, Kaplan-Meier, and Cox proportional hazards regression models were implemented. RESULTS Of 857 patients satisfying inclusion criteria, the majority were male (77.0%) and white (88.1%) with disease of the oral cavity (21.5%) or oropharynx (42.9%) classified as high grade (76.9%) and cT1-2 (72.9%). 389 (45.4%) patients underwent END. END utilization between 2006 and 2017 increased for cT1-2 disease (33.3% vs 56.9%, R2 = .699) but remained relatively constant for cT3-4 disease (66.7% vs 57.9%, R2 = .062). One-hundred and fifteen (29.6%) ENDs detected occult nodal metastases (ONMs). The 5-year overall survival (OS) of patients undergoing neck observation and END was 65.6% and 66.8%, respectively (P = .652). END was not associated with improved OS in survival analyses stratified by patient demographics, clinicopathologic features, and adjuvant therapy. Compared with surgery alone, adjuvant radiotherapy (adjusted hazard ratio: 0.74, 95% confidence interval [CI]: 0.57-0.97, P = .031) was associated with improved OS. END (hazard ratio [HR]: 0.96, 95% CI: 0.71-1.28, P = .770) and ONM (HR: 1.12, 95% CI: 0.78-1.61, P = .551) were not associated with OS. CONCLUSION END is performed in nearly half of patients with HNBC but is not associated with improved OS, even after stratifying survival analyses by patient demographics, clinicopathologic features, and adjuvant therapy. The rate of ONM approaching 30%, however, justifies inclusion of END in the surgical management of HNBC.
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Affiliation(s)
- Aman M Patel
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Afash Haleem
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Hassaam S Choudhry
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Robert M Brody
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Department of Otolaryngology, Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA
| | - Jason A Brant
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Department of Otolaryngology, Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA
| | - Ryan M Carey
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Department of Otolaryngology, Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA
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Sarkar A, Mandal R, Daulat Thakur S. Malignancy with benign course – basaloid squamous cell carcinoma: A rare diagnosis. JOURNAL OF CLINICAL OPHTHALMOLOGY AND RESEARCH 2022. [DOI: 10.4103/jcor.jcor_10_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
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Toe BP, Ramli N, Lam SY, Wong KT, Prepageran N. Basaloid squamous cell carcinoma of the sinonasal tract with metastasis to the liver: a case report and literature review. EAR, NOSE & THROAT JOURNAL 2016; 94:E27-32. [PMID: 25651356 DOI: 10.1177/014556131509400216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
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.
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Affiliation(s)
- Boon Ping Toe
- Department of Diagnostic Imaging, Hospital Sultanah Bahiyah, 05460 Alor Setar, Kedah, Malaysia.
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Al Feghali KA, Traboulsi H, Youssef B. Basaloid Squamous Cell Carcinoma of the Ethmoid Sinus with Invasion into the Skull Base Treated with Craniofacial Resection and Adjuvant Intensity-Modulated Radiation Therapy: A Case Report. Cureus 2015; 7:e421. [PMID: 26835192 PMCID: PMC4726268 DOI: 10.7759/cureus.421] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Basaloid squamous cell carcinoma (BSCC) is a rare variant of squamous cell carcinoma (SCC), which is highly aggressive, with a tendency for multifocality, local invasion, and with a high metastatic potential. Less than forty cases of BSCC of the sinonasal tract have been reported in the literature, and no reports were found on sinonasal BSCC arising from the ethmoid sinus. We report the case of a 78-year-old man who presented with BSCC arising from the ethmoid sinus with extensive bone destruction and intracranial extension. He was treated with craniofacial resection followed by adjuvant intensity-modulated radiation therapy to the tumor bed (60 Gy in 30 fractions), and the upper neck lymph nodes (50 Gy in 25 fractions). At the patient’s last follow-up, four months after diagnosis, there was no evidence of disease. Aggressive management using craniofacial resection followed by adjuvant radiation therapy with or without radiosensitizing chemotherapy seems to be a reasonable approach to this challenging disease.
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Affiliation(s)
| | | | - Bassem Youssef
- Radiation Oncology Department, American University of Beirut Medical Center
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Pathak J, Patel S, Iyer JS, Mohanty N. Basaloid squamous cell carcinoma of the maxilla. BMJ Case Rep 2015; 2015:bcr-2014-209038. [PMID: 26055591 DOI: 10.1136/bcr-2014-209038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
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.
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Affiliation(s)
- Jigna Pathak
- Department of Oral Pathology, MGM Dental College & Hospital, Navi Mumbai, Maharashtra, India
| | - Shilpa Patel
- Department of Oral Pathology, MGM Dental College & Hospital, Navi Mumbai, Maharashtra, India
| | - Janaki Subramanian Iyer
- Department of Oral Pathology, MGM Dental College & Hospital, Navi Mumbai, Maharashtra, India
| | - Neeta Mohanty
- Department of Oral Pathology and Microbiology, Institute of Dental Sciences, Siksha 'O' Anusandhan University, Bhubaneswar, Odisha, India, Institute of Dental Sciences, Bhubaneswar, Odisha, India
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Kuan EC, Peng KA, Bhuta S, Diaz MFP, Zhang ZF, Abemayor E, St. John MA. Basaloid squamous cell carcinoma of the maxilla: Report of a case and literature review. Am J Otolaryngol 2015; 36:402-7. [PMID: 25798549 DOI: 10.1016/j.amjoto.2015.01.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Accepted: 01/25/2015] [Indexed: 11/25/2022]
Abstract
PURPOSE Basaloid squamous cell carcinoma (BSCC) is a rare variant of squamous cell carcinoma characterized by a highly aggressive clinical course. Though typically found in the larynx, oropharynx, and hypopharynx, we report a rare case of BSCC originating in the maxillary sinus in an otherwise healthy 32-year-old male. MATERIALS AND METHODS Single case report of a patient with BSCC of the maxillary sinus and retrospective chart review of all cases of BSCC of the maxilla at a single academic institution between January 1, 1986 and December 31, 2013. The MEDLINE database was additionally queried for all case series or reports of BSCC arising in the maxilla, and pertinent clinical data were extracted. RESULTS The clinical presentation, disease course, and management of a patient with BSCC of the maxilla are presented. In this recent case, the patient presented with persistent alveolar pain and a nonhealing tooth infection. Radiographic studies demonstrated a large necrotic mass in the left maxillary sinus that was biopsy-proven as BSCC. The patient underwent surgical resection followed by postoperative radiation without complications. CONCLUSIONS BSCC of the maxilla is a rare oncologic entity that may progress to late disease stage without obvious clinical signs or symptoms. Optimal treatment involves complete surgical resection followed by postoperative.
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Takamatsu S, Yamamoto K, Kondou T, Kawamura M, Asahi S, Tameshige Y, Maeda Y, Sasaki M, Tamamura H, Tsuji A, Kaizaki Y, Kumano T, Takanaka T. Basaloid squamous cell carcinoma in the nasal cavity treated with proton beam therapy concurrent with cisplatin: a case report. J Med Case Rep 2014; 8:123. [PMID: 24716457 PMCID: PMC4000152 DOI: 10.1186/1752-1947-8-123] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2013] [Accepted: 02/11/2014] [Indexed: 11/10/2022] Open
Abstract
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.
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Affiliation(s)
- Shigeyuki Takamatsu
- Proton Therapy Center, Fukui Prefectural Hospital, 2-8-1 Yotsui, Fukui City, Fukui 910-8526, Japan.
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Ishida M, Okabe H. Basaloid squamous cell carcinoma of the maxillary sinus: Report of two cases in association with cathepsin K expression. Oncol Lett 2013; 5:1755-1759. [PMID: 23833636 PMCID: PMC3700937 DOI: 10.3892/ol.2013.1311] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2012] [Accepted: 04/09/2013] [Indexed: 11/06/2022] Open
Abstract
Basaloid squamous cell carcinoma (BSCC) is a rare variant of squamous cell carcinoma. The occurrence of BSCC in the nasal cavity is extremely rare. In the present study, two cases of BSCC occurring in the maxillary sinus are reported and the clinicopathological features and immunohistochemical characteristics of this rare tumor are discussed. Two patients, aged 85 (case 1) and 60 years (case 2), presented with nasal tumors and persistent nasal obstruction. In each case, the biopsy or resected specimen of the maxillary sinus tumor revealed an infiltrative proliferation of solid epithelial nests composed of basaloid cells exhibiting hyperchromatic nuclei without conspicuous nucleoli and scant cytoplasm. Mitotic figures were frequently observed and spherical hyalinized materials were present within the tumor nests. Immunohistochemically, the tumor cells exhibited diffuse positive immunoreactivity for p63 and perinuclear dot-like positivity for vimentin, leading to a final diagnosis of BSCC of the maxillary sinus. Furthermore, it was demonstrated for the first time in the two cases that cathepsin K, a cysteine protease with marked collagenolytic and elastolytic activities, was expressed in a diffuse manner. One patient (case 2) succumbed to multiple metastases, while the other (case 1) remains alive with the disease. In conclusion, it was demonstrated that cathepsin K was immunopositive in two cases of BSCC of the maxillary sinus and that it may be involved in tumor invasion by this highly aggressive carcinoma.
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Affiliation(s)
- Mitsuaki Ishida
- Department of Clinical Laboratory Medicine and Division of Diagnostic Pathology, Shiga University of Medical Science, Otsu, Shiga, Japan
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Basaloid squamous cell carcinoma of the head and neck: report of 18 cases. The Journal of Laryngology & Otology 2011; 125:608-13. [DOI: 10.1017/s0022215111000491] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractObjective:To evaluate the clinical course and pathological characteristics of basaloid head and neck squamous cell carcinoma.Method:Retrospective study of 18 cases of basaloid head and neck squamous cell carcinoma. Epidemiological, clinical and histological data were analysed and the Kaplan–Meier test used to estimate survival rates.Results:The majority of lesions were at an advanced stage. These lesions were primarily localised in the larynx, hypopharynx and oropharynx. Routine pre-therapeutic assessment of squamous cell carcinoma was performed. Pathological diagnosis was difficult, although immunostaining was extremely useful. Positive staining for KL1, MNF 116 and 34βE12 and negative immunostaining for chromogranin and synaptophysin were also important factors in obtaining a definitive diagnosis. In the majority of cases, treatment involved surgery and radiotherapy. The five-year survival rate was 5 per cent.Conclusion:Basaloid squamous cell carcinoma is an uncommon head and neck lesion, with a challenging histological diagnosis. These lesions must be carefully monitored due to their aggressive course, and require multimodality treatment.
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Gu X, Eskandari F, Fowler M. Sphenoid sinus basaloid squamous cell carcinoma presenting as a sellar mass: report a case with review of the literature. Head Neck Pathol 2010; 5:81-5. [PMID: 20972844 PMCID: PMC3037465 DOI: 10.1007/s12105-010-0214-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2010] [Accepted: 10/06/2010] [Indexed: 11/30/2022]
Abstract
Basaloid squamous cell carcinoma (BSCC) is a distinctive variant of squamous cell carcinoma (SCC) with more aggressive behavior. It occurs preferentially in the upper aerodigestive tract. Sinonasal tract BSCC is uncommon, and only limited studies have been reported in literature. In these studies, most BSCCs arose from the nasal mucosa with or without extension to the paranasal sinuses. Rare reported cases of BSCC involved only the paranasal sinus. In this report, we present a case of a female patient with a sphenoid sinus mass. Clinically, the patient had progressively decreasing vision and headache. Magnetic resonance imaging (MRI) and computerized tomographic (CT) scan showed an infiltrating tumor mass involving the sphenoid sinus and the sella with compression of the optic nerve. Pathologic examination revealed an invasive basaloid epithelial neoplasm that was arranged in lobules, nests and cords. The tumor also showed palisading of peripheral cells, focal abrupt squamous differentiation and in situ carcinoma in the surface mucosa. In the immunohistochemical studies, this tumor revealed a strongly positive nuclear staining for p63. The morphologic and ancillary studies indicated a BSCC. To the best of our knowledge, this is the first report of sinonasal tract BSCC that mainly involved the sphenoid bone and sella. In this region, BSCC should be distinguished from benign and malignant neoplasms that more often affect sella and base of skull, such as pituitary adenoma with extensive necrosis, small cell neuroendocrine carcinoma (SCNC), olfactory neuroblastoma, malignant germ cell tumor, paranasal adenoid cystic carcinoma (ACC), and a variety of metastatic malignancies.
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Affiliation(s)
- Xin Gu
- Department of Pathology, Louisiana State University Health Science Center-Shreveport, 1501 Kings Highway, Shreveport, LA 71130 USA
| | - Farzan Eskandari
- Department of Pathology, Louisiana State University Health Science Center-Shreveport, 1501 Kings Highway, Shreveport, LA 71130 USA
| | - Marjorie Fowler
- Department of Pathology, Louisiana State University Health Science Center-Shreveport, 1501 Kings Highway, Shreveport, LA 71130 USA
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Vasudev P, Boutross-Tadross O, Radhi J. Basaloid squamous cell carcinoma: two case reports. CASES JOURNAL 2009; 2:9351. [PMID: 20062602 PMCID: PMC2804002 DOI: 10.1186/1757-1626-2-9351] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/06/2009] [Accepted: 12/18/2009] [Indexed: 11/10/2022]
Abstract
Basaloid squamous cell carcinoma (BSCC) is a rare and aggressive variant of squamous cell carcinoma (SCC) that occurs preferentially in the upper aerodigestive tract. We present two cases of BSCC, one arising in the conjunctiva and the other arising in a paranasal sinus. Clinical and pathological findings in these two cases, including immunohistochemistry is presented along with brief discussion of literature. To the best of our knowledge, this is the first report of BSCC of the conjunctiva. BSCC of the head and neck should be distinguished from adenoid cystic carcinoma, small cell neuroendocrine carcinoma, basal cell adenocarcinoma, adenosquamous carcinoma, squamous cell carcinoma, spindle cell squamous carcinoma, mucoepidermoid carcinoma, and adenoid cystic carcinoma.
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Affiliation(s)
- Pooja Vasudev
- Department of Pathology, McMaster University, 1200 Main Street West, Hamilton, Ontario, L8N 3V7, Canada
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