Head and Neck Pathology

, Volume 2, Issue 2, pp 83–91 | Cite as

Basaloid Squamous Cell Carcinoma of the Head and Neck

A Clinicopathological and Follow-Up Study of 40 Cases and Review of the Literature
  • Cosme Ereño
  • Ayman Gaafar
  • Maddi Garmendia
  • Carmen Etxezarraga
  • Francisco J. Bilbao
  • José I. López
Review Paper


Basaloid squamous cell carcinoma (BSCC) is a rare and aggressive variant of cancer that mainly arises in the upper aerodigestive tract. This study reviews the clinico-pathological features and follow-up of a series of cases occurring in the head and neck. During a 32-year period (1974–2005), a total of 40 BSCCs have been diagnosed in the head and neck in our Institution. Males predominated in the series (35M/5F). The average age was 60.2 years (range, 40–85). Tobacco and alcohol consumption was found in more than 80% of the cases. Topographic distribution was as follows: larynx and hypopharynx, 22 cases (55%); oropharynx, 12 cases (30%); and oral cavity 6 cases (15%). The basaloid component predominated in 29 cases (72.5%). Vasculo-lymphatic invasion was detected in 5 cases (12.5%). Lymph node metastases were seen in 25 cases (62.5%, levels II and III in the neck dissection). Local recurrences appeared in 11 cases (27.5%) and distant metastases in 6 (15%). In 7 cases (17.5%) a second primary tumour was detected. The 2002 TNM staging was as follows: Stage I, 5 cases (12.5%); Stage II, 7 cases (17.5%); Stage III, 8 cases (20%), and Stage IV, 20 cases (50%). On follow-up, 21 cases (52.5%) are alive and 19 (47.5%) died of disease. Three- and 5-year overall survival was 50% and 38.5%, respectively. A significant shorter survival was detected in node positive patients (P<0.05).


Basaloid-squamous cell carcinoma Head and neck Larynx Hypopharynx Oropharynx Oral cavity Differential diagnosis Prognosis Recurrence Metastasis 


  1. 1.
    Wain SL, Kier R, Wollmer RT, et al. Basaloid-squamous carcinoma of the tongue, hypopharynx, and larynx: report of 10 cases. Hum Pathol. 1986;17:1158–66.PubMedCrossRefGoogle Scholar
  2. 2.
    Banks ER, Frierson HF Jr, Mills SE, et al. Basaloid squamous cell carcinoma of the head and neck. A clinicopathologic and immunohistochemical study of 40 cases. Am J Surg Pathol. 1992;16:939–46.PubMedCrossRefGoogle Scholar
  3. 3.
    Barnes L. Basaliod squamous cell carcinoma. In: Barnes L, editor Surgical pathology of the head and neck, 2nd ed. New York: Marcel Dekker, 2001. p. 184–89.Google Scholar
  4. 4.
    Luna MA, El Naggar A, Parichatikanond P, et al. Basaloid squamous carcinoma of the upper aeorodigestive tract. Clinicopathologic and DNA flow cytometric analysis. Cancer. 1990;66:537–42.PubMedCrossRefGoogle Scholar
  5. 5.
    Paulino AFG, Singh B, Shah JP, et al. Basaloid squamous cell carcinoma of the head and neck. Laryngoscope. 2000;110:1479–82.PubMedCrossRefGoogle Scholar
  6. 6.
    Hellquist HB, Dahl F, Karlsson MG, et al. Basaloid squamous cell carcinoma of the palate. Histopathology. 1994;25:178–80.PubMedCrossRefGoogle Scholar
  7. 7.
    Coppola D, Catalano E, Tang CK, et al. Basaloid squamous cell carcinoma of the floor of the mouth. Cancer. 1993;72:2299–305.PubMedCrossRefGoogle Scholar
  8. 8.
    Ide F, Shimoyama T, Horie N, et al. Basaloid squamous cell carcinoma of the oral mucosa: a new cases and review of 45 cases in the literature. Oral Oncol. 2002;38:120–4.PubMedCrossRefGoogle Scholar
  9. 9.
    Wieneke JA, Thompson LD, Wenig BM. Basaloid squamous cell carcinoma of the sinonasal tract. Cancer. 1999;85:841–54.PubMedCrossRefGoogle Scholar
  10. 10.
    Wan SK, Chan JKC, Lau WH, et al. Basaloid-squamous carcinoma of the nasopharynx. An Epstein-Barr virus-associated neoplasm compared with morphologically identical tumors occurring in other sites. Cancer. 1995;76:1689–93.PubMedCrossRefGoogle Scholar
  11. 11.
    Saltarelli MG, Fleming MV, Wenig BM, et al. Primary basaloid squamous cell carcinoma of the trachea. Am J Clin Pathol. 1995;104:594–98.PubMedGoogle Scholar
  12. 12.
    Sarbia M, Verreet P, Bittinger F, et al. Basaloid squamous cell carcinoma of the esophagus. Diagnosis and prognosis. Cancer. 1997;79:1871–78.PubMedCrossRefGoogle Scholar
  13. 13.
    Brambilla E, Moro D, Veale D, et al. Basal cell (basaloid) carcinoma of the lung: A new morphologic and phenotypic entity with a separate prognostic significance. Hum Pathol. 1992;23:993–1003.PubMedCrossRefGoogle Scholar
  14. 14.
    Chetty R, Serra S, Hsieh E. Basaloid squamous carcinoma of the anal canal with and adenoid cystic pattern. Histologic and immunohistochemical reappraisal of an unusual variant. Am J Surg Pathol. 2005;29:1668–72.PubMedCrossRefGoogle Scholar
  15. 15.
    Brainard J, Hart W. Adenoid basal epitheliomas of the uterine cervix: a reevaluation of distinctive cervical basaloid lesions currently classified as adenoid basal carcinoma and adenoid basal hyperplasia. Am J Surg Pathol. 1998;22:965–75.PubMedCrossRefGoogle Scholar
  16. 16.
    Cubilla AL, Reuter VE, Gregoire L, et al. Basaloid squamous cell carcinoma: distinctive human papillomavirus related penile neoplasm. A report of 20 cases. Am J Surg Pathol. 1998;22:755–61.PubMedCrossRefGoogle Scholar
  17. 17.
    Vakar-López F, Abrams J. Basaloid squamous cell carcinoma occurring in the urinary bladder. Arch Pathol Lab Med. 2000;124:455–9.PubMedGoogle Scholar
  18. 18.
    Greene FL, Page DL, Fleming ID, et al., editors. AJCC cancer staging handbook. TNM classification of malignant tumors. New York, 2002.Google Scholar
  19. 19.
    Cardesa A; Zidar N, Ereño C. Basaloid squamous cell carcinoma. In: Barnes L, Eveson JW, Reichart P, Sidrasky D, editors. Pathology and genetics of head and neck tumours. Kleihues P, Sobón LH, series editors. World Health Organization classification of tumours. Lyon, France: IARC Press; 2005. p. 124–5.Google Scholar
  20. 20.
    Kleist B, Bankau A, Lorenz G, et al. Different risk factors in basaloid and common squamous head and neck cancer. Laryngoscope. 2004;114:1063–68.PubMedCrossRefGoogle Scholar
  21. 21.
    El-Mofty SK, Patil S. Human papillomavirus (HPV)-related oropharyngeal nonkeratinizing squamous cell carcinoma: characterization of a distinct phenotype. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006;101:339–45.PubMedCrossRefGoogle Scholar
  22. 22.
    Cabanillas R, Rodrigo JP, Ferlito A, et al. Is there an epidemiological link between human papillomavirus DNA and basaloid squamous cell carcinoma of the pharynx? Oral Oncol. 2007;43:327–32.PubMedCrossRefGoogle Scholar
  23. 23.
    Thompson LDR. Basaloid squamous cell carcinoma (BSCC). In: Thompson LDR, Golblum JR, editors. Head and neck pathology. Philadelphia: Churchill Livingstone; 2006. p. 70–3.Google Scholar
  24. 24.
    Muller S, Barnes L. Basaloid squamous cell carcinoma of the head and neck with a spindle cell component. An unusual histologic variant. Arch Pathol Lab Med. 1995;119:181–2.PubMedGoogle Scholar
  25. 25.
    Kimura T, Mukai M, Shiotani A, et al. Basaloid squamous carcinoma of the hypopharynx with an extensive spindle cell component exhibiting a pedunculated polypoid mass. Arch Pathol Lab Med. 2005;129:94–6.Google Scholar
  26. 26.
    Altrabulsi B, Carrizo F, Luna MA. Spindle basaloid squamous carcinoma of the upper aerodigestive tract: immunohistochemical and clinicopathological study of three cases. Ann Diagn Pathol. 2006;10:149–53.PubMedCrossRefGoogle Scholar
  27. 27.
    Banks ER, Frierson HF, Covell JL. Fine needle aspiration cytologic findings in metastatic basaloid squamous cell carcinoma of the head and neck. Acta Cytol. 1992; 36:126–31.PubMedGoogle Scholar
  28. 28.
    Zamecnik M, Skalova A, Pelikan K, et al. Basaloid squamous carcinoma with collagenous spherules and crystaloids. Ann Diagn Pathol. 2001;5:233–9.PubMedCrossRefGoogle Scholar
  29. 29.
    Morice WG, Ferreiro JA. Distinction of basaloid squamous cell carcinoma from adenoid cystic and small cell undifferentiated carcinoma by immunohistochemistry. Hum Pathol. 1998;29:609–12.PubMedCrossRefGoogle Scholar
  30. 30.
    Hunt JL, Barnes L. Immunohistology of head and neck neoplasms. Basaloid squamous cell carcinoma. In: Dabbs DJ, editor. Diagnostic immunohistochemistry, 2nd ed. Philadelphia: Churchill Livingstone; 2006. p. 229–30.Google Scholar
  31. 31.
    Klijanienko J, El- Naggar A, Ponzio-Priom A, et al. Basaloid squamous carcinoma of the head and neck. Immunohistochemical comparison with adenoid cystic carcinoma and squamous cell carcinoma. Arch Otolaryngol Head Neck Surg. 1993;119:887–90.PubMedGoogle Scholar
  32. 32.
    Coletta RD, Almeida OP, Vargas PA. Cytokeratins 1, 7 and 14 immunoexpression are helpful in the diagnosis of basaloid squamous cell carcinoma. Histopathology. 2006;48:773–4.PubMedCrossRefGoogle Scholar
  33. 33.
    Emanuel P, Wang B, Wu M, et al. p63 immunohistochemistry in the distinction of adenoid cystic carcinoma from basaloid squamous cell carcinoma. Mod Pathol. 2005;18:645–50.PubMedCrossRefGoogle Scholar
  34. 34.
    De Sampaio G, Grizzo FC, Oliviera DT, et al. Prognosis of oral basaloid squamous cell carcinoma and squamous cell carcinoma: a comparison. Arch Otolaryngol Head Neck Surg. 2004;130:83–6.CrossRefGoogle Scholar
  35. 35.
    Winzenburg SM, Niehans GA, George E, et al. Basaloid squamous carcinoma: a clinical comparison of two histologic types with poorly differentiated squamous cell carcinoma. Otolaryngol Head Neck Surg. 1998;119:471–5.PubMedCrossRefGoogle Scholar
  36. 36.
    Erdamar B, Suoglu Y, Sirin M, et al. Basaloid squamous cell carcinoma of the supraglottic larynx. Eur Arch Otolaryngol. 2000;257:154–7.CrossRefGoogle Scholar
  37. 37.
    Erisen LM, Coskun H, Ozuysal S, et al. Basaloid squamous cell carcinoma of the larynx: a report of four new cases. Laryngoscope. 2004;114:1179–83.PubMedCrossRefGoogle Scholar
  38. 38.
    Bahar G, Feinmesser R, Popovtzer A, et al. Basaloid squamous carcinoma of the larynx. Am J Otolaryngol. 2003;24:204–8.PubMedCrossRefGoogle Scholar
  39. 39.
    Rodriguez Tojo MJ, Garcia Cano FJ, Infante Sanchez JC, et al. Immunoexpression of p53, Ki-67 and E-Cadherin in basaloid squamous cell carcinoma of the larynx. Clin Transl Oncol. 2005;7:100–4.CrossRefGoogle Scholar
  40. 40.
    Salerno G, Di Vizio D, Staibano S, et al. Prognostic value of p27Kip1 expression in Basaloid Squamous Cell Carcinoma of the Larynx. BMC Cancer. 2006;6:146.PubMedCrossRefGoogle Scholar
  41. 41.
    Marioni G, Octaviano G, Marchese-Ragona R, et al. High nuclear expression of the apoptosis inhibitor protein is associated with disease recurrence and poor prognosis in laryngeal basaloid squamous cell carcinoma. Acta Oto-Laryngol. 2006;126:197–203.CrossRefGoogle Scholar
  42. 42.
    McKay MJ, Bilous AM. Basaloid squamous carcinoma of the hypopharynx. Cancer. 1989;63:2528–31.PubMedCrossRefGoogle Scholar
  43. 43.
    Seidman JD, Berman JJ, Yost BA, et al. Basaloid squamous carcinoma of the hypopharynx and larynx associated with second primary tumors. Cancer. 1991;68:1545–49.PubMedCrossRefGoogle Scholar
  44. 44.
    Lam KY, Law S, Luk JM, et al. Oesophageal basaloid squamous cell carcinoma: a unique clinicopathological entity with telomerase activity as a prognostic indicator. J Pathol. 2001;195:435–42.PubMedCrossRefGoogle Scholar

Copyright information

© Humana 2008

Authors and Affiliations

  • Cosme Ereño
    • 1
  • Ayman Gaafar
    • 1
  • Maddi Garmendia
    • 1
  • Carmen Etxezarraga
    • 1
  • Francisco J. Bilbao
    • 1
  • José I. López
    • 2
  1. 1.Department of Pathology, Hospital de Basurto Basque Country UniversityBilbaoSpain
  2. 2.Department of Pathology, Hospital de Cruces, BarakaldoBasque Country University (EHU/UPV)BizkaiaSpain

Personalised recommendations