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Born LJ, Khachemoune A. Basal cell carcinosarcoma: a systematic review and reappraisal of its challenges and the role of Mohs surgery. Arch Dermatol Res 2023; 315:2195-2205. [PMID: 36790451 DOI: 10.1007/s00403-023-02551-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 12/23/2022] [Accepted: 01/22/2023] [Indexed: 02/16/2023]
Abstract
Basal cell carcinosarcoma (BCCS) is a rare malignant biphasic tumor of the skin, composed of epithelial and mesenchymal components, and may be underdiagnosed. We sought to summarize the current understanding of BCCS including its reported history, clinical presentation, diagnosis, and treatment. We also reappraise and present our recommendations of histological interpretation for its diagnosis and treatment. A systematic review of PubMed and EMBASE, from inception of databases to December 1, 2022, identified all reported cases of basal cell carcinosarcoma. A total of 34 reports containing 54 patients with basal cell carcinosarcoma were included. The neoplasm was most commonly associated in areas of sun-exposed skin and primarily affected the elderly. Diagnosis was made on histology specimens using H&E. To address underdiagnosis, additional immunohistochemical markers have been proposed due to unreliable phenotypic appearance in this poorly differentiated neoplasm. Treatment consists of excision of the tumor, typically with Mohs surgery, and is curative in most cases. There are limited treatment options for metastatic disease. There were limitations to this study as various immunohistochemical stains used on suspected BCCS without providing an explanation as to why certain markers were included and others were excluded. Continued efforts in characterizing this complex neoplasm are critical in establishing reliable and accurate diagnostic tests and accompanying treatment options, especially in cases of metastatic disease.
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Affiliation(s)
- Louis J Born
- Department of Dermatology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Amor Khachemoune
- Department of Dermatology, Veterans Affairs Medical Center, and State University of New York, New York, NY, USA.
- Veterans Affairs Hospital and SUNY Downstate Dermatology Service, 800 Poly Place, Brooklyn, NY, 11209, USA.
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Fried S, Suhrawardy A, Rehman R, Al-Jamal M, Moore D, Mehregan D. Metastatic osteosarcoma involving the skin: A systematic review of patient demographics, clinical characteristics, and treatment outcomes. J Am Acad Dermatol 2023; 88:470-471. [PMID: 35718194 DOI: 10.1016/j.jaad.2022.06.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 05/24/2022] [Accepted: 06/07/2022] [Indexed: 01/17/2023]
Affiliation(s)
- Sarah Fried
- Oakland University William Beaumont School of Medicine, Rochester, Michigan.
| | - Ameen Suhrawardy
- Oakland University William Beaumont School of Medicine, Rochester, Michigan
| | - Rafey Rehman
- Department of Dermatology, Wayne State University School of Medicine, Detroit, Michigan
| | - Malik Al-Jamal
- Wayne State University School of Medicine, Detroit, Michigan
| | - Drew Moore
- Department of Orthopaedic Surgery, William Beaumont Hospital, Royal Oak, Michigan
| | - Darius Mehregan
- Department of Dermatology, Wayne State University School of Medicine, Detroit, Michigan
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Seine AJ, Aronson A, Tallon B, Mortimer NJ. A rare cutaneous tumour. Clin Exp Dermatol 2022; 47:791-794. [PMID: 34984725 DOI: 10.1111/ced.15050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/16/2021] [Indexed: 11/29/2022]
Abstract
A clinicopathological correlation case of a rare cutaneous tumour, which demonstrated a very rare recurrence with uncertainty remaining over the long-term prognosis for the patient.
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Affiliation(s)
| | | | - B Tallon
- Skin Dermatology Institute, Tauranga Specialist Centre, Tauranga, New Zealand
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DEREBAŞINLIOĞLU H, NEMMEZİ KARACA S. A 20-YEAR RETROSPECTIVE ANALYSIS OF SKIN CANCERS: COMPARISON OF THE FIRST AND SECOND DECADES. KONURALP TIP DERGISI 2020. [DOI: 10.18521/ktd.708364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Leecy T, Ardakani NM, Harvey NT, Wood BA. Pilomatrical carcinosarcoma: report of a case with comparative genomic hybridisation analysis. Pathology 2018; 50:571-573. [PMID: 29954591 DOI: 10.1016/j.pathol.2018.02.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 02/16/2018] [Accepted: 02/22/2018] [Indexed: 11/25/2022]
Affiliation(s)
- Tamazin Leecy
- PathWest Laboratory Medicine, QEII Medical Centre, Nedlands, WA, Australia.
| | | | - Nathan T Harvey
- PathWest Laboratory Medicine, QEII Medical Centre, Nedlands, WA, Australia
| | - Benjamin A Wood
- PathWest Laboratory Medicine, QEII Medical Centre, Nedlands, WA, Australia
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6
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Xu C, Ibbetson J, Yeoh TM, Harries RHC. Aggressive growth of an incompletely excised primary cutaneous basal cell carcinosarcoma on the scalp: a case report. ANZ J Surg 2016; 86:1065-1066. [PMID: 27910277 DOI: 10.1111/ans.13620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Accepted: 03/28/2016] [Indexed: 11/26/2022]
Affiliation(s)
- Chris Xu
- Department of Plastic and Reconstructive Surgery, The Queen Elizabeth Hospital, Adelaide, South Australia, Australia
| | - Jan Ibbetson
- Department of Surgical Pathology, SA Pathology, Adelaide, South Australia, Australia
| | - Tze Ming Yeoh
- Department of Plastic and Reconstructive Surgery, The Queen Elizabeth Hospital, Adelaide, South Australia, Australia
| | - Richard H C Harries
- Department of Plastic and Reconstructive Surgery, The Queen Elizabeth Hospital, Adelaide, South Australia, Australia
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Clark JJ, Bowen AR, Bowen GM, Hyngstrom JR, Hadley ML, Duffy K, Florell SR, Wada DA. Cutaneous carcinosarcoma: a series of six cases and a review of the literature. J Cutan Pathol 2016; 44:34-44. [DOI: 10.1111/cup.12843] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Revised: 10/05/2016] [Accepted: 10/06/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Joshua J. Clark
- Department of Dermatology; University of Utah; Salt Lake City UT USA
| | - Anneli R. Bowen
- Department of Dermatology; University of Utah; Salt Lake City UT USA
| | - Glen M. Bowen
- Department of Dermatology; University of Utah; Salt Lake City UT USA
- Department of Dermatology; Huntsman Cancer Institute; Salt Lake City UT USA
| | - John R. Hyngstrom
- Department of Surgery; University of Utah and Huntsman Cancer Institute; Salt Lake City UT USA
| | - Michael L. Hadley
- Department of Dermatology; University of Utah; Salt Lake City UT USA
| | - Keith Duffy
- Department of Dermatology; University of Utah; Salt Lake City UT USA
| | - Scott R. Florell
- Department of Dermatology; University of Utah; Salt Lake City UT USA
| | - David A. Wada
- Department of Dermatology; University of Utah; Salt Lake City UT USA
- Department of Dermatology; Huntsman Cancer Institute; Salt Lake City UT USA
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8
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Ghannem L, Debbi K, Kerdraon R, Michenet P, Lecointre C. [Bone in skin]. Ann Pathol 2016; 36:155-8. [PMID: 26996973 DOI: 10.1016/j.annpat.2016.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2015] [Revised: 12/10/2015] [Accepted: 01/15/2016] [Indexed: 11/15/2022]
Affiliation(s)
- Lila Ghannem
- Service de pathologie, hôpital La Source, 14, avenue de l'Hôpital, 45067 Orléans cedex 2, France.
| | - Kamel Debbi
- Service de pathologie, hôpital La Source, 14, avenue de l'Hôpital, 45067 Orléans cedex 2, France
| | - Rémy Kerdraon
- Service de pathologie, hôpital La Source, 14, avenue de l'Hôpital, 45067 Orléans cedex 2, France
| | - Patrick Michenet
- Service de pathologie, hôpital La Source, 14, avenue de l'Hôpital, 45067 Orléans cedex 2, France
| | - Claire Lecointre
- Service de pathologie, hôpital La Source, 14, avenue de l'Hôpital, 45067 Orléans cedex 2, France
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Harms PW, Fullen DR, Patel RM, Chang D, Shalin SC, Ma L, Wood B, Beer TW, Siddiqui J, Carskadon S, Wang M, Palanisamy N, Fisher GJ, Andea A. Cutaneous basal cell carcinosarcomas: evidence of clonality and recurrent chromosomal losses. Hum Pathol 2015; 46:690-7. [PMID: 25704628 DOI: 10.1016/j.humpath.2015.01.006] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2014] [Accepted: 01/03/2015] [Indexed: 10/24/2022]
Abstract
Cutaneous carcinosarcomas are heterogeneous group of tumors composed of malignant epithelial and mesenchymal components. Although mutation analyses have identified clonal changes between these morphologically disparate components in some subtypes of cutaneous carcinosarcoma, few cases have been analyzed thus far. To our knowledge, copy number variations (CNVs) and copy-neutral loss of heterozygosity (CN-LOH) have not been investigated in cutaneous carcinosarcomas. We analyzed 4 carcinosarcomas with basal cell carcinoma and osteosarcomatous components for CNVs/CN-LOH by comparative genomic hybridization/single-nucleotide polymorphism array, TP53 hot spot mutations by polymerase chain reaction and Sanger sequencing, and TP53 genomic rearrangements by fluorescence in situ hybridization. All tumors displayed multiple CNV/CN-LOH events (median, 7.5 per tumor). Three of 4 tumors displayed similar CNV/CN-LOH patterns between the epithelial and mesenchymal components within each tumor, supporting a common clonal origin. Recurrent changes included allelic loss at 9p21 (CDKN2A), 9q (PTCH1), and 17p (TP53). Allelic losses of chromosome 16 including CDH1 (E-cadherin) were present in 2 tumors and were restricted to the sarcomatous component. TP53 mutation analysis revealed an R248L mutation in both epithelial and mesenchymal components of 1 tumor. No TP53 rearrangements were identified. Our findings indicate that basal cell carcinosarcomas harbor CNV/CN-LOH changes similar to conventional basal cell carcinoma, with additional changes including recurrent 9p21 losses and a relatively high burden of copy number changes. In addition, most cutaneous carcinosarcomas show evidence of clonality between epithelial and mesenchymal components.
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Affiliation(s)
- Paul W Harms
- Department of Pathology, University of Michigan Health System, Ann Arbor MI 48109; Department of Dermatology, University of Michigan Health System, Ann Arbor MI 48109; Michigan Center for Translational Pathology, University of Michigan Health System, Ann Arbor MI 48109.
| | - Douglas R Fullen
- Department of Pathology, University of Michigan Health System, Ann Arbor MI 48109; Department of Dermatology, University of Michigan Health System, Ann Arbor MI 48109
| | - Rajiv M Patel
- Department of Pathology, University of Michigan Health System, Ann Arbor MI 48109; Department of Dermatology, University of Michigan Health System, Ann Arbor MI 48109
| | - Dannie Chang
- Department of Dermatology, University of Michigan Health System, Ann Arbor MI 48109
| | - Sara C Shalin
- Departments of Pathology and Dermatology, University of Arkansas for Medical Sciences, Little Rock, AR 72205
| | - Linglei Ma
- Miraca Life Sciences, Glen Burnie, MD 21061
| | - Benjamin Wood
- School of Pathology and Laboratory Medicine, University of Western Australia, Perth, WA 6009, Australia
| | - Trevor W Beer
- CliniPath Pathology, Osborne Park, WA 6017, Australia
| | - Javed Siddiqui
- Department of Pathology, University of Michigan Health System, Ann Arbor MI 48109; Michigan Center for Translational Pathology, University of Michigan Health System, Ann Arbor MI 48109
| | | | - Min Wang
- Department of Pathology, University of Michigan Health System, Ann Arbor MI 48109
| | - Nallasivam Palanisamy
- Department of Pathology, University of Michigan Health System, Ann Arbor MI 48109; Michigan Center for Translational Pathology, University of Michigan Health System, Ann Arbor MI 48109; Department of Urology, Henry Ford Health System, Detroit, MI 48202; King Saud University, Riyadh, Saudi Arabia 11362
| | - Gary J Fisher
- Department of Dermatology, University of Michigan Health System, Ann Arbor MI 48109
| | - Aleodor Andea
- Department of Pathology, University of Michigan Health System, Ann Arbor MI 48109; Department of Dermatology, University of Michigan Health System, Ann Arbor MI 48109
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