Basal cell carcinoma develops in contact with the epidermal basal cell layer - a three-dimensional morphological...

Area of Science:

• Dermatopathology
• Oncology
• Skin Cancer Research

Background:

• Basal cell carcinoma (BCC) is the most common skin malignancy.
• BCC often affects difficult-to-treat areas and can exhibit aggressive growth.
• Mild and aggressive BCC types share biological features, potentially explaining their low metastatic rate.

Purpose of the Study:

• To investigate shared biological and morphological features of mild and aggressive BCC.
• To analyze the connection points between BCC and the basal cell layer or hair follicles.
• To correlate these connections with tumor behavior and clinical presentation.

Main Methods:

• High-resolution 3D reconstruction technique.
• Analysis of 15 pathological samples from superficial, fibrosing, and adenoid BCC.
• Quantification of contact points and bridging with epidermal/follicular basal cells.

Main Results:

• All BCC types exhibited contact points/bridges with the basal cell layer or hair follicles.
• Fibrosing BCC showed the highest connection rate (100%), followed by superficial (85.71%) and adenoid (55%).
• Adenoid BCC displayed stronger inter-island connections forming a 'tumor lace'; inflammatory infiltrate affected morphology.

Conclusions:

• BCC types demonstrate varying degrees of connection to the epidermal/follicular basal layer.
• The number and morphology of bridging points may influence BCC's biological and clinical manifestations.
• These findings offer insights into BCC behavior and recurrence risk.