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Metastatic basosquamous carcinoma detected by sentinel lymph node biopsy
Yuichi Yoshida1, Tatsushi Shiomi, Makoto Tahira
1Division of Dermatology, Department of Medicine of Sensory and Motor Organs, Tottori University, Faculty of Medicine, Yonago, Japan. yxy@grape.med.tottori-u.ac.jp
The Journal of Dermatology
|June 4, 2013
Summary
Basosquamous carcinoma (BSC) is a rare skin cancer with a worse prognosis than basal cell carcinoma (BCC) and a potential for metastasis. Sentinel lymph node biopsy may aid in managing high-risk BSC cases.
Area of Science:
- Dermatology
- Oncology
- Pathology
Background:
- Basosquamous carcinoma (BSC) is an uncommon skin neoplasm exhibiting features of both basal cell carcinoma (BCC) and squamous cell carcinoma (SCC).
- Understanding the metastatic potential and optimal management strategies for BSC is crucial due to its aggressive nature.
Observation:
- A rare case of BSC on the thigh of a 69-year-old male is presented.
- Dermoscopy revealed ulceration, atypical leaf-like areas, and linear-irregular vessels.
- Histopathology confirmed mixed BCC and SCC features, with positive sentinel lymph node biopsy (SLNB).
Findings:
- The patient developed in-transit and iliac lymph node metastases despite complete inguinal lymphadenectomy.
- Immunostaining confirmed focal positivity for Ber-EP4 in invasive tumor cells.
- BSC demonstrates a poorer prognosis and higher metastatic potential compared to BCC.
Implications:
- Sentinel lymph node biopsy may be indicated for high-risk BSC, particularly those larger than 3 cm.
- Careful follow-up is essential for patients diagnosed with BSC.
- This case highlights the aggressive behavior of BSC and the importance of thorough staging and monitoring.
