Metastatic Basal Cell Carcinoma

Author:

Laga Alvaro C1,Schaefer Inga Marie1,Sholl Lynette M1,French Christopher A1,Hanna John1

Affiliation:

1. Department of Pathology, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA

Abstract

Abstract Objectives Diagnosis of metastatic basal cell carcinoma (BCC) remains challenging, in part due to its rarity. With the advent of molecularly targeted therapies, recognition of this entity is more important than ever. Methods We identified 11 cases of metastatic BCC over a 13-year period. We analyzed these tumors in conjunction with their respective primary tumors by histomorphologic, immunohistochemical, and molecular genetic analyses. Results We identified three morphologic patterns of metastasis in BCC. The most common (seven cases) was characterized by completely typical features of BCC. Two cases showed marked squamous differentiation within BCC. The final two cases showed exclusively features of a poorly differentiated carcinoma. One of these was definitively classified by molecular analysis, as both the primary and metastatic tumors harbored the same inactivating PTCH1 mutation. Conclusions This study illustrates multiple distinct morphologic patterns in metastatic BCC and highlights the utility of ancillary molecular testing for accurate diagnosis.

Funder

National Institutes of Health

Publisher

Oxford University Press (OUP)

Subject

General Medicine

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