Basal Cell Carcinoma with Mixed Histology: a Possible Pathogenesis for Recurrent Skin Cancer

Overview

Journal Dermatol Surg

Date 2006 May 10

PMID 16681663

Citations 23

Authors

Philip R Cohen

Keith E Schulze

Bruce R Nelson

Affiliations

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Abstract

Background: Basal cell carcinoma with mixed histology (BCC-MH) demonstrates more than one pathologic pattern of tumor. Appropriate therapy for the nonaggressive tumor subtype diagnosed from a superficial biopsy may not be adequate to treat the unsuspected aggressive tumor subtype, resulting in recurrent skin cancer.

Objective: We prospectively evaluated the incidence and characteristics of BCC-MH.

Methods: Mohs surgical sections were evaluated for BCC-MH.

Results: BCC-MH was observed in 43% (49/144) of cancers. Only 10% (5/49) of the biopsy reports from these cancers diagnosed BCC-MH. Most BCC-MH were previously untreated (90% [44/49] of tumors) and were located on the nose.

Conclusion: More than 40% of basal cell carcinomas referred for removal of the residual tumor were BCC-MH. An unsuspected aggressive pathologic pattern of growth may not be detected after a superficial biopsy. Subsequently, the cancer may recur if the initial treatment for the diagnosed nonaggressive tumor subtype is inadequate for the undiscovered aggressive carcinoma. Mohs micrographic surgery is recommended for BCC-MH treatment.

Citing Articles

Cutaneous Basal Cell Carcinoma In Situ: A Review of the World Literature.

Cohen P, Kurzrock R Cureus. 2024; 16(9):e69691.

PMID: 39429413 PMC: 11489863. DOI: 10.7759/cureus.69691.

Concordance of basal cell carcinoma subtyping at biopsy vs. excision, and the implications for clinical approach: a multicenter cohort study.

Alam M, Whittington A, Nadir U, Yi M, Dave L, Hisham F Arch Dermatol Res. 2023; 316(1):23.

PMID: 38059991 DOI: 10.1007/s00403-023-02772-6.

Weakly supervised detection and classification of basal cell carcinoma using graph-transformer on whole slide images.

Yacob F, Siarov J, Villiamsson K, Suvilehto J, Sjoblom L, Kjellberg M Sci Rep. 2023; 13(1):7555.

PMID: 37160953 PMC: 10169852. DOI: 10.1038/s41598-023-33863-z.

Cutaneous Basal Cell Carcinoma In Situ: A Case Series.

Cohen P Cureus. 2022; 14(9):e29479.

PMID: 36299923 PMC: 9588167. DOI: 10.7759/cureus.29479.

Nodular and Micronodular Basal Cell Carcinoma Subtypes Are Different Tumors Based on Their Morphological Architecture and Their Interaction with the Surrounding Stroma.

Serbanescu M, Bungardean R, Georgiu C, Crisan M Diagnostics (Basel). 2022; 12(7).

PMID: 35885545 PMC: 9323345. DOI: 10.3390/diagnostics12071636.