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Pleomorphic basal cell carcinoma

J A Garcia1, P R Cohen, A J Herzberg

  • 1Department of Dermatology, University of Texas-Houston Medical School 77030, USA.

Journal of the American Academy of Dermatology
|May 1, 1995
PubMed
Summary
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Pleomorphic basal cell carcinoma (BCC) exhibits large, atypical cells but behaves like ordinary BCC. These tumors, often on the head and neck, show no recurrences after treatment.

Area of Science:

  • Dermatopathology
  • Oncology
  • Cell Biology

Background:

  • Basal cell carcinoma (BCC) can present with unusual variants, including those with large, pleomorphic cells, previously termed "basal cell epithelioma with giant tumor cells" or "basal cell carcinoma with monster cells."
  • Understanding these variants is crucial for accurate diagnosis and patient management.

Purpose of the Study:

  • To characterize the clinical, histological, and DNA ploidy features of basal cell carcinomas (BCCs) displaying significant cellular atypia.
  • To compare the behavior of these pleomorphic BCCs to conventional BCCs.

Main Methods:

  • Prospective collection of 19 pleomorphic BCCs and retrospective review of other BCCs from 15 patients.
  • Histological analysis using light microscopy and image analysis for DNA ploidy on formalin-fixed, paraffin-embedded tissues.

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  • Clinical follow-up data was collected for recurrence assessment.

    • Main Results:

    • Pleomorphic BCCs, typically located on the head and neck, ranged from 2.8 to 12.5 mm and showed characteristic BCC features alongside giant pleomorphic cells.
    • Aneuploidy was detected in all studied pleomorphic BCCs, with giant tumor cell DNA content not being a multiple of a single DNA value.
    • No recurrences were observed in the pleomorphic BCCs during a median follow-up of 20 months.

    Conclusions:

    • Pleomorphic BCCs present clinically similar to typical BCCs.
    • Despite significant focal cellular atypia, these lesions demonstrate a clinical behavior comparable to ordinary BCCs, suggesting a favorable prognosis.