BerEP4-Negative Basal Cell Carcinoma: An Immunophenotype Not to Forget

Area of Science:

• Oncology
• Immunohistochemistry
• Dermatopathology

Background:

• Basal cell carcinoma (BCC) is the most prevalent cancer globally, characterized by local invasiveness.
• BerEP4, an antibody targeting CD326 (EpCAM), shows high sensitivity for BCC but variable sensitivity for other carcinomas.
• Accurate diagnosis is crucial due to BCC's potential for local destruction.

Observation:

• A case study of a 74-year-old woman with a basal cell carcinoma.
• The tumor was negative for BerEP4 but positive for an anti-renal cell antibody.
• This presentation deviates from the typical BerEP4-positive profile of BCC.

Findings:

• The basal cell carcinoma in this case was uniquely BerEP4-negative.
• The tumor exhibited positivity for an anti-renal cell antibody.
• This atypical immunophenotype complicates standard diagnostic approaches.

Implications:

• Misdiagnosis of BerEP4-negative BCC can occur, especially when other markers are positive.
• Clinicians must consider the possibility of BerEP4-negative BCC, irrespective of other positive findings.
• This case underscores the importance of comprehensive diagnostic evaluation in oncology.