Basaloid squamous carcinoma of the larynx. A potential diagnostic pitfall

Transoral laryngeal microsurgery for early-stage laryngeal basaloid squamous cell carcinoma

A 71-year-old man presented to our otolaryngology clinic with dysphagia and dyspnoea. He had a history of smoking for 40 years. Laryngoscopy showed an exophytic, round mass on the left aryepiglottic fold that was entirely excised by transoral laser CO2 microsurgery. Histological assessment revealed a pT1 basaloid squamous cell carcinoma (BSCC) with free-margin resection. He underwent close follow-up and after 3-year follow-up, the patient was free from disease. Laryngeal BSCC is a rare cancer with poor prognosis due to its late diagnosis and early neck node metastases. We report a rare case of early tumour treated by endoscopic surgery without complications or recurrence of disease. However, knowing this type of cancer and making a correct differential diagnosis are important to guarantee the best therapy and prognosis.

How phenotype guides management of non-conventional squamous cell carcinomas of the larynx?

Although the majority of laryngeal malignancies are the conventional squamous cell carcinomas (SCC), a wide variety of malignant epithelial tumors can affect the larynx. Current treatment guidelines are designed to guide clinicians in management of conventional laryngeal SCC. Less is known about the biological behavior and responsiveness to therapy and overall outcomes of other malignant epithelial lesions. Because a spectrum of disease biology is represented by these rare phenotypes, an understanding of the basic biology can help direct management to optimize clinical outcome in this group of patients. This review provides a critical analysis of literature relating to the diagnosis, management, and outcome of patients with non-conventional squamous malignant epithelial neoplasms of the larynx. Particular attention is paid to features which are at variance with the conventional SCC and how these impact on management of these rare tumors.

Basaloid squamous cell carcinoma of the head and neck: report of 18 cases

Objective:

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.