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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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2
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Mineshige T, Kamiie J, Ishikawa M, Shirota K. Malignant Trichoblastoma with Sarcomatous Stroma in a Rabbit. J Comp Pathol 2022; 199:109-113. [DOI: 10.1016/j.jcpa.2022.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Revised: 07/21/2022] [Accepted: 10/07/2022] [Indexed: 11/22/2022]
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3
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Suemune K, Adachi Y, Takagi M, Tokuriki T, Akiyama H, Ikehara S. Pilomatrical carcinosarcoma in the very elderly: A case report. Mol Clin Oncol 2021; 15:264. [PMID: 34777800 PMCID: PMC8581733 DOI: 10.3892/mco.2021.2426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 07/21/2021] [Indexed: 11/06/2022] Open
Abstract
Pilomatrical carcinosarcomas are very rare tumors. To the best of our knowledge, only nine cases diagnosed with pilomatrical carcinosarcomas have been reported. The present study reported on a case of pilomatrical carcinosarcoma in the posterior part of the left auricle of a 100-year-old male patient. The tumor histologically comprised the following two components: Pilomatrical carcinoma and undifferentiated spindle cell sarcoma. The pilomatrical carcinoma comprised atypical basaloid cells and shadow cells. The basaloid cells had basophilic cytoplasm, clear nucleoli and deeply stained nuclear chromatin. The undifferentiated spindle cell sarcoma comprised atypical spindle cells. Both components contained numerous mitotic cells. The boundary area between the carcinoma and sarcoma smoothly transitioned into each other. The carcinoma cells and a portion of the sarcoma cells were positive for β-catenin in the cytoplasm with or without the nuclei. These results suggested that the two components developed from the same origin.
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Affiliation(s)
- Kazuki Suemune
- Department of Diagnostic Pathology, Toyooka Hospital, Toyooka, Hyogo 668-8501, Japan
| | - Yasushi Adachi
- Department of Diagnostic Pathology, Toyooka Hospital, Toyooka, Hyogo 668-8501, Japan.,Department of Pediatrics, Kansai Medical University, Hirakata, Osaka 573-1010, Japan.,Medical Department, Keishinkai Ayabe Sakura Home, Ayabe, Kyoto 623-0045, Japan
| | - Masayuki Takagi
- Department of Laboratory Medicine, Shizuoka Medical Center, Shimizu-Cho, Shizuoka 411-8611, Japan
| | - Toshiharu Tokuriki
- Department of Plastic and Reconstructive Surgery, Toyooka Hospital, Toyooka, Hyogo 668-8501, Japan
| | - Hajime Akiyama
- Department of Dermatology, Toyooka Hospital, Toyooka, Hyogo 668-8501, Japan
| | - Susumu Ikehara
- Department of Stem Cell Disorders, Kansai Medical University, Hirakata, Osaka 573-1010, Japan
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4
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Heathcote J, Moss P, Walsh N, Archibald C. Basal cell carcinosarcoma of the eyelid with osteosarcomatous transformation. Saudi J Ophthalmol 2021; 35:257-260. [PMID: 35601854 PMCID: PMC9116097 DOI: 10.4103/sjopt.sjopt_35_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 03/03/2021] [Accepted: 06/07/2021] [Indexed: 11/21/2022] Open
Abstract
A carcinosarcoma is a neoplasm with malignant epithelial and mesenchymal components. It is thought to arise by mesenchymal transformation of the epithelial elements. The cutaneous form of carcinosarcoma is rare and is associated with sun exposure; most cases arise in the head and neck. The epithelial component may be a basal cell carcinoma, a squamous cell carcinoma, or an adnexal carcinoma. The mesenchymal component may be an osteosarcoma, a pleomorphic undifferentiated sarcoma, or another type of sarcoma. Only a few cases of cutaneous carcinosarcoma have been described in the periocular skin. We present a case of basal cell carcinosarcoma with osteosarcoma and pleomorphic undifferentiated sarcoma arising in the lower eyelid of an elderly man.
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5
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Left Ear Nodule: Answer. Am J Dermatopathol 2021; 43:78-79. [PMID: 33337627 DOI: 10.1097/dad.0000000000001565] [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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6
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Metastatic Basal Cell Carcinoma of the Skin: A Comprehensive Literature Review, Including Advances in Molecular Therapeutics. Adv Anat Pathol 2020; 27:331-353. [PMID: 32618586 DOI: 10.1097/pap.0000000000000267] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Basal cell carcinoma (BCC) of the skin is the most common type of malignant human tumor. In Europe, the incidence of BCC ranges from 44.6 to 128 cases per 100,000 inhabitants annually, whereas in the United States, the yearly incidence rate ranges between 500 and 1500. The global incidence has been calculated to be as high as 10 million cases of BCC per year. There are 2 main clinical patterns of BCC-the familial BCC in basal cell nevus syndrome and sporadic BCC. The etiology of cutaneous BCC is usually the result of the interaction between solar ultraviolet radiation and genetic factors. Somatic or germline mutations in the effector components of the hedgehog signaling pathway (ie, PTCH1, PTCH2, SMO or SUFU genes) are responsible for ∼90% of the cases of both sporadic and familial BCC, all causing a constitutive activation of the hedgehog pathway. Cutaneous BCC very rarely metastasizes, and diagnosis in metastatic sites can be very difficult. Metastatic BCC has weakly effective therapeutic options with a poor prognosis until few years ago. In 2012, small-molecule therapies, involving inactivation of the hedgehog signaling pathway, and capable of reducing tumor growth and progression have been introduced into clinical practice for advanced (locally advanced or metastatic) BCC. We performed a comprehensive literature review on metastatic BCC and found at least 915 cases reported to date. In addition, we extensively discussed the differential diagnosis of metastatic BCC, and outlined the advances in clinical therapeutics involving these small molecules.
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7
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Song EY, Wallace SJ, Sheikh H, Wojcik R, Nayak C. Cutaneous Carcinosarcoma: A Small Case Series and Review of the Literature of a Rare Skin Tumor. Cureus 2020; 12:e9569. [PMID: 32913686 PMCID: PMC7474563 DOI: 10.7759/cureus.9569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Carcinosarcomas are composed of epithelial and mesenchymal elements and primarily present within visceral organs. Despite being potentially aggressive, they are a rare diagnosis in the skin, and few manifestations have been reported to date. In this report, we describe two separate cases of carcinosarcoma presenting as nonhealing scalp wounds. Patient A: a 57-year-old male with a nonhealing skin lesion of ten years successfully treated with wide-local excision and local ortichochea flap reconstruction. Patient B: a 75-year-old female that presented with a painless, slow-growing hemorrhagic mass of 7 years invading the skull and dura ultimately requiring craniectomy and free-tissue transfer with anterolateral thigh flap. Cutaneous carcinosarcomas have more favorable outcomes due to low metastatic rates likely due to earlier detection, but delayed presentation can be fatal. Histopathological analysis is critical for determining diagnosis and prognosis. Adequate reconstruction after wide base excision varies and follows the reconstructive ladder/elevator ranging from primary closure up through free-tissue transfer. With cutaneous manifestations of carcinosarcoma seldom reported in the literature, it is our hope that reporting unusual instances such as this will raise awareness and allow for earlier diagnoses, treatments, and reconstructions.
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Affiliation(s)
- Ethan Y Song
- Plastic and Reconstructive Surgery, University of South Florida Morsani College of Medicine, Tampa, USA
| | - Sean J Wallace
- Division of Plastic & Reconstructive Surgery, Lehigh Valley Health Network, Allentown, USA
| | - Hina Sheikh
- Pathology, Health Network Laboratories, Allentown, USA
| | - Randolph Wojcik
- Division of Plastic & Reconstructive Surgery, Lehigh Valley Health Network, Allentown, USA
| | - Chetan Nayak
- Otolaryngology, Lehigh Valley Health Network, Allentown, USA
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García-Souto F, Pereyra-Rodriguez JJ, Cabrera-Perez R, Durán-Romero AJ, Escudero-Ordoñez J, Conejo-Mir J. Primary cutaneous carcinosarcoma: clinical, histological, and immunohistochemical analysis of eight cases. Int J Dermatol 2020; 60:93-98. [PMID: 32530054 DOI: 10.1111/ijd.14996] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 04/24/2020] [Accepted: 05/12/2020] [Indexed: 12/01/2022]
Abstract
BACKGROUND Cutaneous carcinosarcoma is a rare biphasic tumor comprising malignant epithelial and heterologous mesenchymal elements. Data on the clinical and histopathologic characteristics of this tumor are scarce. The objective of this study was to describe the clinicopathologic and immunohistochemical features of cutaneous carcinosarcoma. METHODS A descriptive retrospective study was conducted in a tertiary care hospital from Spain. We reviewed the records of eight patients with cutaneous carcinosarcoma who were diagnosed from 2009 to 2019. RESULTS The mean patient age at diagnosis was 72.13 years (range 44-91 years), and there was a male predilection (6 cases). The most common site of cutaneous carcinosarcoma was the head and neck (5 cases). Carcinosarcomas demonstrated variable histopathological and immunohistochemical features. Follow-up was available for 7-8 patients. There were two cases of local recurrence and one case of metastasis. Two patients died from the tumor during the entire follow-up. CONCLUSIONS Although the number of cases in this study was limited, our results provide valuable insight into the clinical, histopathologic, and immunohistochemical characteristics of primary cutaneous carcinosarcoma.
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Affiliation(s)
| | | | - Rocío Cabrera-Perez
- Department of Pathology, Hospital Universitario Virgen del Rocío, Seville, Spain
| | | | | | - Julián Conejo-Mir
- Department of Dermatology, Hospital Universitario Virgen del Rocío, Seville, Spain
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9
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Mestre-Alagarda C, Monteagudo C. Reply to "Primary cutaneous biphasic sarcomatoid basal cell carcinoma with myoepithelial carcinoma differentiation. Is it a new variant of sarcomatoid basal cell carcinoma or a collision tumor composed of a myoepithelial carcinoma and an incidental basal cell carcinoma?". J Cutan Pathol 2020; 47:578-580. [PMID: 32181509 DOI: 10.1111/cup.13685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 03/13/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Claudia Mestre-Alagarda
- Department of Anatomic Pathology, Hospital Clínico Universitario de Valencia, Valencia, Spain
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10
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Bisceglia M, Panniello G, Nirchio V, Sanguedolce F, Centola M, Ben-Dor DJ. Metastatic Cutaneous Basal Cell Carcinoma: Report of 2 Cases Preceding the Hedgehog Pathway Antagonists Era. Adv Anat Pathol 2020; 27:98-111. [PMID: 31895095 DOI: 10.1097/pap.0000000000000259] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Basal cell carcinoma (BCC) of the skin is the most common type of malignant human tumor. However, metastatic BCC is a very rare event with weakly effective therapeutic options and a poor prognosis, until a few years ago. In 2012, small-molecule therapies, capable of inactivating the hedgehog signaling pathway and thus reducing tumor growth and progression, were introduced into clinical practice for the treatment of patients with advanced BCC. We present retrospectively 2 personal cases of metastatic BCC of the skin, from the premolecular therapy era, from primary tumors that arose years before in the head and neck area. The former case occurred in a 45-year-old woman with a history of recurrent BCC of the retroauricular skin who eventually died due to diffuse metastatic spread. The latter case concerned a 70-year-old man also with a history of recurrent BCC of the nasal-perinasal skin who developed multiple subcutaneous and lymph node metastases in the neck. In both cases, the diagnoses were based on biopsies of the metastatic sites. The first patient died 5 months after the diagnosis of metastatic disease, while the second was alive and disease-free 2 years after neck lymph node dissection and external radiation therapy, and then lost to follow-up. We extensively discuss several tumor entities with basal or basaloid features that may enter the differential diagnosis with BCC in metastatic sites. In addition, we briefly summarize the advances in clinical therapeutics using small molecules, which are now an integral part of the treatment of such advanced BCC cases.
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11
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Davis K, Whale K, Tran S, Hamilton S, Kandamany N. A rare case of cutaneous basal cell carcinosarcoma in an immunosuppressed patient. Pathology 2020; 52:267-268. [PMID: 31918851 DOI: 10.1016/j.pathol.2019.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 09/26/2019] [Accepted: 10/13/2019] [Indexed: 11/24/2022]
Affiliation(s)
- Katherine Davis
- Department of Plastic and Reconstructive Surgery, Royal Hobart Hospital, Hobart, Australia.
| | - Karen Whale
- Department of Anatomical Pathology, Royal Hobart Hospital, Hobart, Australia
| | - Sonia Tran
- Department of Plastic and Reconstructive Surgery, Royal Hobart Hospital, Hobart, Australia
| | - Sam Hamilton
- Department of Plastic and Reconstructive Surgery, Royal Hobart Hospital, Hobart, Australia
| | - Nanda Kandamany
- Department of Plastic and Reconstructive Surgery, Royal Hobart Hospital, Hobart, Australia
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12
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Mestre-Alagarda C, Nieto G, Terrádez L, Monteagudo C. Primary cutaneous biphasic sarcomatoid basal cell carcinoma with myoepithelial carcinoma differentiation: A new variant. J Cutan Pathol 2019; 46:949-953. [PMID: 31278765 DOI: 10.1111/cup.13543] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 06/14/2019] [Accepted: 07/03/2019] [Indexed: 12/01/2022]
Abstract
Isolated cases of basal cell carcinoma (BCC) with partial myoepithelial component have been described. However, myoepithelial differentiation has not been described in sarcomatoid basal cell carcinomas, which usually show features resembling osteosarcoma, chondrosarcoma, or leiomyosarcoma. We report a case of an 87-year-old man with a forehead lesion that histologically showed a minor component of conventional nodular BCC in transition with a major biphasic sarcomatoid growth composed of invasive spindle-cell and epithelial-like components, the latter with a reticular pattern and scattered ductal structures. Both components showed cytological atypia and high mitotic rate (26/10HPF), with atypical mitotic figures. BER-EP4 immunostaining was exclusively found in the nodular BCC component whereas the sarcomatoid component revealed immunostaining for α-smooth muscle actin (SMA), muscle-specific actin (MSA), calponin, and p63 in both epithelial-like and spindle-cell populations. Focal immunoreactivity was observed in the epithelial component for S100 and glial fibrillary acidic protein (GFAP). Furthermore, EWSR1-PBX1 gene fusion was also detected. This is to our knowledge, the first fully documented case of biphasic sarcomatoid BCC with myoepithelial carcinoma differentiation.
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Affiliation(s)
- Claudia Mestre-Alagarda
- Department of Pathology, Hospital Clínico Universitario, Universitat de Valencia, Valencia, Spain
| | - Gema Nieto
- Department of Pathology, Hospital Clínico Universitario, Universitat de Valencia, Valencia, Spain
| | - Liria Terrádez
- Department of Pathology, Hospital Clínico Universitario, Universitat de Valencia, Valencia, Spain
| | - Carlos Monteagudo
- Department of Pathology, Hospital Clínico Universitario, Universitat de Valencia, Valencia, Spain
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13
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Li JJX, Ng JKM, Choi PCL, Lee JHS, Yu MY. Trichoblastic Carcinosarcoma Arising From the Vagina: A Case Report With Comprehensive Immunophenotypic Analysis. Int J Surg Pathol 2019; 28:440-446. [PMID: 31747847 DOI: 10.1177/1066896919887803] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
A 54-year-old woman presented with abdominal pain. Magnetic resonance imaging revealed an upper vaginal mass with no pelvic side wall involvement, nodal, or distant metastasis. Radical hysterectomy was performed. Histology showed trichoblastic carcinoma with hair follicle structures and malignant sarcomatous and carcinomatous components. Hair follicular differentiation was confirmed by positivity to hair follicle markers (Bcl-2, TLE1, CD56/NCAM, and TDAG51) and presence of CD10-positive trichogenic stroma. The tumor involved the vaginal muscularis only (FIGO [International Federation of Gynecology and Obstetrics] stage I) and was excised with clear margins. The patient remained disease free at 3-month follow-up. This is the first case of cutaneous-type carcinosarcoma reported in the vagina, highlighting the difference in histology, immunophenotype, and behavior compared with gynecologic carcinosarcomas.
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Affiliation(s)
- Joshua Jing Xi Li
- Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong
| | - Joanna Ka Man Ng
- Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong
| | - Paul Cheung Lung Choi
- Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong
| | - Jacqueline Ho Sze Lee
- Department of Obstetrics and Gynaecology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong
| | - Mei-Yung Yu
- Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong
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Lucena SR, Zamarrón A, Carrasco E, Marigil MA, Mascaraque M, Fernández-Guarino M, Gilaberte Y, González S, Juarranz A. Characterisation of resistance mechanisms developed by basal cell carcinoma cells in response to repeated cycles of Photodynamic Therapy. Sci Rep 2019; 9:4835. [PMID: 30886381 PMCID: PMC6423284 DOI: 10.1038/s41598-019-41313-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Accepted: 03/04/2019] [Indexed: 02/06/2023] Open
Abstract
Photodynamic Therapy (PDT) with methyl-aminolevulinate acid (MAL-PDT) is being used for the treatment of Basal cell carcinoma (BCC), but recurrences have been reported. In this work, we have evaluated resistance mechanisms to MAL-PDT developed by three BCC cell lines (ASZ, BSZ and CSZ), derived from mice on a ptch+/- background and with or without p53 expression, subjected to 10 cycles of PDT (10thG). The resistant populations showed mesenchymal-like structure and diminished proliferative capacity and size compared to the parental (P) cells. The resistance was dependent on the production of the endogenous photosensitiser protoporphyrin IX in the CSZ cell line and on its cellular localisation in ASZ and BSZ cells. Moreover, resistant cells expressing the p53 gene presented lower proliferation rate and increased expression levels of N-cadherin and Gsk3β (a component of the Wnt/β-catenin pathway) than P cells. In contrast, 10thG cells lacking the p53 gene showed lower levels of expression of Gsk3β in the cytoplasm and of E-cadherin and β-catenin in the membrane. In addition, resistant cells presented higher tumorigenic ability in immunosuppressed mice. Altogether, these results shed light on resistance mechanisms of BCC to PDT and may help to improve the use of this therapeutic approach.
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Affiliation(s)
- Silvia Rocio Lucena
- Biology Department, Faculty of Sciences, Autonomous University of Madrid, Madrid, Spain
| | - Alicia Zamarrón
- Biology Department, Faculty of Sciences, Autonomous University of Madrid, Madrid, Spain
| | - Elisa Carrasco
- Molecular Biology Department, Faculty of Sciences, Autonomous University of Madrid, Madrid, Spain
| | | | - Marta Mascaraque
- Biology Department, Faculty of Sciences, Autonomous University of Madrid, Madrid, Spain
| | | | | | - Salvador González
- Medicine and Medical Specialties Department, Alcalá de Henares University, Madrid, Spain
| | - Angeles Juarranz
- Biology Department, Faculty of Sciences, Autonomous University of Madrid, Madrid, Spain.
- Instituto Ramón y Cajal de Investigaciones Sanitarias, IRYCIS, Madrid, Spain.
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Yunoki T, Tabuchi Y, Hirano T, Miwa S, Imura J, Hayashi A. Gene networks in basal cell carcinoma of the eyelid, analyzed using gene expression profiling. Oncol Lett 2018; 16:6729-6734. [PMID: 30405815 DOI: 10.3892/ol.2018.9484] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Accepted: 09/13/2018] [Indexed: 12/26/2022] Open
Abstract
Basal cell carcinoma (BCC) is the most frequent malignant tumor of the eyelid; it progresses slowly and rarely metastasizes. However, BCC of the eyelid is partially invasive and can extend to the surrounding ocular adnexa even if appropriate treatment is performed. To understand the molecular mechanism underlying its pathogenesis, global gene expression analysis of surgical tissue samples of BCC of the eyelid (n=2) and normal human epidermal keratinocytes was performed using a GeneChip® system. The histopathological examination of surgically removed eyelid tissues showed the tumor nest composed with small basaloid. In the samples from patients 1 and 2, 687 and 713 genes were identified, respectively, demonstrating ≥5.0-fold higher expression than that noted in normal human epidermal keratinocytes. For the 640 genes with upregulated expression in both patient samples, Ingenuity® pathway analysis showed that the gene network in BCC of the eyelid included many BCC-associated genes, such as the following: BCL2 apoptosis regulator; Patched-1; and SRY-box 9. In addition, unique gene networks related to cancer cell growth, tumorigenesis, and cell survival were identified. These results of integrating microarray analyses provide further insights into the molecular mechanisms involved in BCC of the eyelid and may provide a therapeutic approach for this disease.
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Affiliation(s)
- Tatsuya Yunoki
- Department of Ophthalmology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama 930-0194, Japan
| | - Yoshiaki Tabuchi
- Division of Molecular Genetics Research, Life Science Research Center, University of Toyama, Toyama 930-0194, Japan
| | - Tetsushi Hirano
- Division of Molecular Genetics Research, Life Science Research Center, University of Toyama, Toyama 930-0194, Japan
| | - Shigeharu Miwa
- Department of Diagnostic Pathology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama 930-0194, Japan
| | - Johji Imura
- Department of Diagnostic Pathology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama 930-0194, Japan
| | - Atsushi Hayashi
- Department of Ophthalmology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama 930-0194, Japan
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16
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Suzuki H, Hashimoto A, Saito R, Izumi M, Aiba S. A Case of Primary Cutaneous Basal Cell Carcinosarcoma. Case Rep Dermatol 2018; 10:208-215. [PMID: 30283313 PMCID: PMC6167722 DOI: 10.1159/000492525] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 07/29/2018] [Indexed: 01/21/2023] Open
Abstract
A 94-year-old man consulted our hospital due to a rapidly growing tumor on the left cheek. The histological diagnosis of the tumor was basal cell carcinosarcoma, which was composed of intermingled epithelial and mesenchymal components. The former was basal cell carcinoma, while the latter was spindle cell sarcoma. The tumor was completely resected with a 3-mm margin and the patient remained free of local recurrence or distinct metastasis for 2 years. We report here a case of cutaneous basal cell carcinosarcoma and a review of the literature.
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Affiliation(s)
- Hiromi Suzuki
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Akira Hashimoto
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Ryoko Saito
- Department of Pathology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Miki Izumi
- Department of Medical Education, Showa University School of Medicine, Sendai, Japan
| | - Setsuya Aiba
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
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17
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Wu J, Qing Y, Cen Y, Chen J. Frontal axial pattern flap combined with hard palate mucosa transplant in the reconstruction of midfacial defects after the excision of huge basal cell carcinoma. World J Surg Oncol 2018; 16:120. [PMID: 29958532 PMCID: PMC6027767 DOI: 10.1186/s12957-018-1421-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 06/22/2018] [Indexed: 02/05/2023] Open
Abstract
Background Our article describes our experience with using a frontal axial pattern flap combined with hard palate mucosa transplant to reconstruct midfacial defects after the excision of huge basal cell carcinoma. Methods We retrospectively reviewed four patients diagnosed with midface huge basal cell carcinoma through biopsy between 2014 and 2016. Both the eyelid and nose were involved in all the patients. All the patients underwent the studied surgical method and were followed up from 12 to 36 months. Results All the patients preserved good eyelid function and relatively good esthetic satisfaction. No basal cell carcinoma recurred. Conclusions This combined surgical procedure is a good method for reconstructing defects after the excision of huge basal cell carcinomas in the midface.
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Affiliation(s)
- Junliang Wu
- Department of Plastic and Burn Surgery, West China School of Medicine, West China Hospital, Sichuan University, No.37, Guoxue Alley, Chengdu, 610041, Sichuan Province, China
| | - Yong Qing
- Department of Plastic and Burn Surgery, West China School of Medicine, West China Hospital, Sichuan University, No.37, Guoxue Alley, Chengdu, 610041, Sichuan Province, China.
| | - Ying Cen
- Department of Plastic and Burn Surgery, West China School of Medicine, West China Hospital, Sichuan University, No.37, Guoxue Alley, Chengdu, 610041, Sichuan Province, China
| | - Junjie Chen
- Department of Plastic and Burn Surgery, West China School of Medicine, West China Hospital, Sichuan University, No.37, Guoxue Alley, Chengdu, 610041, Sichuan Province, China
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18
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Lim Y, Byun HJ, Park CS, Lee JH, Park JH, Lee JH, Lee DY. Primary cutaneous carcinosarcoma developing after chronic C-arm radiation exposure. JAAD Case Rep 2018; 4:126-128. [PMID: 29387761 PMCID: PMC5789523 DOI: 10.1016/j.jdcr.2017.07.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
| | | | | | | | | | | | - Dong-Youn Lee
- Correspondence to: Dong-Youn Lee, MD, PhD, Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon Ro, Gangnam Gu, Seoul 06351, Republic of Korea.Department of DermatologySamsung Medical CenterSungkyunkwan University School of Medicine81 Irwon Ro, Gangnam GuSeoul06351Republic of Korea
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19
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Wollina U, Riedel I, Abushika MR, Lotti T, Tchernev G. Giant Pendulous Carcinosarcoma - Squamous Cell Carcinoma-Type - of the Leg - A Case Report and Review of the Literature. Open Access Maced J Med Sci 2018; 6:112-114. [PMID: 29484002 PMCID: PMC5816276 DOI: 10.3889/oamjms.2018.036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Revised: 10/30/2017] [Accepted: 10/31/2017] [Indexed: 11/05/2022] Open
Abstract
Cutaneous carcinosarcoma (CCS) is a rare non-melanoma skin cancer with a biphasic growth pattern. A tumour is composed of epithelial and mesenchymal cells that show clonality. In most cases, CCS develops in the head-and-neck region on the chronic sun-exposed skin of males. Here, we describe an 80-year-old female patient who developed a giant, pendulous CCS on the leg. A tumour was surgically removed. We found no evidence of metastatic spread.
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Affiliation(s)
- Uwe Wollina
- Städtisches Klinikum Dresden - Department of Dermatology and Allergology, Dresden, Sachsen, Germany
| | - Ina Riedel
- Städtisches Klinikum Dresden - Institute of Pathology "Georg Schmorl" Dresden, Sachsen, Germany
| | - Mohammad R Abushika
- Städtisches Klinikum Dresden - Department of Dermatology and Allergology, Dresden, Sachsen, Germany
| | - Torello Lotti
- University G. Marconi of Rome - Dermatology and Venereology, Rome, Italy
| | - Georgi Tchernev
- Department of Dermatology, Venereology and Dermatologic Surgery, Medical Institute of Ministry of Interior, Sofia, Bulgaria.,Onkoderma, Policlinic for Dermatology and Dermatologic Surgery, Sofia, Bulgaria
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20
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Cutaneous Metaplastic Carcinoma: Report of a Case With Sebaceous Differentiation. Am J Dermatopathol 2018; 40:e100-e103. [PMID: 29293124 DOI: 10.1097/dad.0000000000001070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
In this study, a case of a 56-year-old woman with cutaneous metaplastic carcinoma in the neck is reported. It harbored basal cell carcinoma, squamous cell carcinoma, and sebaceous carcinoma, as well as osteosarcoma (with fibroblastic, osteoblastic, aneurysmal bone cyst-like, and chondroblastic patterns). To our knowledge, the literature does not mention sebaceous carcinoma in cutaneous metaplastic carcinoma. Epidemiology and intact mismatch repair proteins of this case support sporadic pathogenesis for this neoplasm. The patient has been followed up for 3 years after surgery with free margins, and no local recurrence or distant metastases have been observed.
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21
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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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22
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Vilas-Sueiro A, Fernández-Jorge B, Pérez-Valcárcel J, Monteagudo B. Primary metaplastic carcinoma with osteogenic sarcoma and squamous cell carcinoma differentiation. J Cutan Pathol 2016; 43:1081-1082. [PMID: 27584912 DOI: 10.1111/cup.12781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Revised: 05/18/2016] [Accepted: 08/03/2016] [Indexed: 10/21/2022]
Affiliation(s)
| | | | | | - Benigno Monteagudo
- Department of Dermatology, University Hospital Complex Ferrol, Ferrol, Spain
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