Das Basalzellkarzinom und seine seltenen Formvarianten

Basal cell carcinoma and rare form variants


Basalzellkarzinome sind die häufigsten primären kutanen malignen Neoplasien. Die Diagnose eines Basalzellkarzinoms stellt für Pathologen und Dermatopathologen eine entsprechend häufige und täglich vorkommende Routine dar. Ziel dieses Übersichtsartikels ist die klinische und histopathologische Darstellung der häufigsten Subtypen des Basalzellkarzinoms, und es werden die seltenen Formvarianten sowie deren Differenzialdiagnosen erläutert.


Basal cell carcinomas are the most common primary cutaneous malignant neoplasms. The diagnosis of basal cell carcinoma represents a common and routine task for pathologists and dermatopathologists. The aim of this review is the clinical and histopathological presentation of the most common subtypes of basal cell carcinoma. Furthermore, the rare variants of basal cell carcinoma and their differential diagnoses are also discussed.

This is a preview of subscription content, log in to check access.

Abb. 1
Abb. 2
Abb. 3
Abb. 4
Abb. 5
Abb. 6
Abb. 7
Abb. 8
Abb. 9
Abb. 10
Abb. 11
Abb. 12


  1. 1.

    Ackerman AB (1988) Basal cell carcinoma with follicular differentiation. Reply. Am J Dermatopathol 10:458–466

    Article  Google Scholar 

  2. 2.

    Aloi FG, Molinero A, Pippione M (1988) Basal cell carcinoma with matrical differentiation. Matrical carcinoma. Am J Dermatopathol 10:509–513

    CAS  PubMed  Article  Google Scholar 

  3. 3.

    Bahadoran P, Perrin C, Aberdam D et al (1997) Altered expression of the hemidesmosome-anchoring filament complex proteins in basal cell carcinoma: possible role in the origin of peritumoral lacunae. Br J Dermatol 136:35–42

    CAS  PubMed  Article  Google Scholar 

  4. 4.

    Bale AE (1997) The nevoid basal cell carcinoma syndrome: genetics and mechanisms of carcinogenesis. Cancer Invest 15:180–186

    CAS  PubMed  Article  Google Scholar 

  5. 5.

    Bale AE, Gailani MR, Leffell DJ (1994) Nevoid basal cell carcinoma syndrome. J Invest Dermatol 103(Suppl 5):S126–S130

    Article  Google Scholar 

  6. 6.

    Batra RS, Kelley LC (2002) Predictors of extensive subclinical spread in nonmelanoma skin cancer treated with Mohs micrographic surgery. Arch Dermatol 138:1043–1051

    PubMed  Article  Google Scholar 

  7. 7.

    Bowen AR, LeBoit PE (2005) Fibroepithelioma of Pinkus is a fenestrated trichoblastoma. Am J Dermatopathol 27:149–154

    PubMed  Article  Google Scholar 

  8. 8.

    Brown CI, Perry AE (2000) Incidence of perineural invasion in histologically aggressive types of basal cell carcinoma. Am J Dermatopathol 22:123–125

    CAS  PubMed  Article  Google Scholar 

  9. 9.

    Corona R, Dogliotti E, D’Errico M et al (2001) Risk factors for basal cell carcinoma in a Mediterranean population: role of recreational sun exposure early in life. Arch Dermatol 137:1162–1168

    CAS  PubMed  Article  Google Scholar 

  10. 10.

    Crawford KM, Kobayashi T (2004) Nevoid basal cell carcinoma syndrome or multiple hereditary infundibulocystic basal cell carcinoma syndrome? J Am Acad Dermatol 51:989–995

    PubMed  Article  Google Scholar 

  11. 11.

    Crowson AN (2006) Basal cell carcinoma: biology, morphology and clinical implications. Mod Pathol 19(Suppl 2):S127–S147

    PubMed  Article  Google Scholar 

  12. 12.

    Diffey BL, Langtry JA (2005) Skin cancer incidence and the ageing population. Br J Dermatol 153:679–680

    CAS  PubMed  Article  Google Scholar 

  13. 13.

    Dixon AY, Lee SH, McGregor DH (1993) Histologic features predictive of basal cell carcinoma recurrence: results of a multivariate analysis. J Cutan Pathol 20:137–142

    CAS  PubMed  Article  Google Scholar 

  14. 14.

    Farmer ER, Helwig EB (1980) Metastatic basal cell carcinoma: a clinicopathologic study of seventeen cases. Cancer 46:748–757

    CAS  PubMed  Article  Google Scholar 

  15. 15.

    Gallagher RP, Hill GB, Bajdik CD et al (1995) Sunlight exposure, pigmentary factors, and risk of nonmelanocytic skin cancer. I. Basal cell carcinoma. Arch Dermatol 131:157–163

    CAS  PubMed  Article  Google Scholar 

  16. 16.

    Goeteyn M, Geerts ML, Kint A et al (1994) The Bazex-Dupré-Christol syndrome. Arch Dermatol 130:337–342

    CAS  PubMed  Article  Google Scholar 

  17. 17.

    Goldberg LH (1996) Basal cell carcinoma. Lancet 347:663–667

    CAS  PubMed  Article  Google Scholar 

  18. 18.

    Guo HR, Yu HS, Hu H et al (2001) Arsenic in drinking water and skin cancers: cell-type specificity (Taiwan, ROC). Cancer Causes Control 12:909–916

    CAS  PubMed  Article  Google Scholar 

  19. 19.

    Haupt HM, Stern JB, Dilaimy MS (2000) Basal cell carcinoma. Clues to its presence in histologic sections when the initial slide is nondiagnostic. Am J Surg Pathol 24:1291–1294

    CAS  PubMed  Article  Google Scholar 

  20. 20.

    Hendrix JD, Parlette HL (1996) Micronodular basal cell carcinoma: a deceptive histologic subtype with frequent clinically undetected tumor extension. Arch Dermatol 132:295–298

    PubMed  Article  Google Scholar 

  21. 21.

    Hutcheson ACS, Fisher AH, Lang PG Jr (2005) Basal cell carcinomas with unusual histologic patterns. J Am Acad Dermatol 53:833–837

    PubMed  Article  Google Scholar 

  22. 22.

    Jedrych J, Busam KJ (2014) Multiple lesions of granular cell basal cell carcinoma: a case report. J Cutan Pathol 41:45–50

    PubMed  Article  Google Scholar 

  23. 23.

    Jemec GB, Holm EA (2003) Nonmelanoma skin cancer in organ transplant patients. Transplantation 75:253–257

    PubMed  Article  Google Scholar 

  24. 24.

    Kato N, Ueno H (1993) Infundibulocystic basal cell carcinoma. Am J Dermatopathol 15:265–267

    CAS  PubMed  Article  Google Scholar 

  25. 25.

    Kim MY, Park HJ, Baek SC et al (2002) Mutations of the p53 and PTCH gene in basal cell carcinomas: UV mutation signature and strand bias. J Dermatol Sci 29:1–9

    PubMed  Article  Google Scholar 

  26. 26.

    Kim YC, Vandersteen DP, Chung YJ et al (2001) Signet ring cell basal cell carcinoma. A basal cell carcinoma with myoepithelial differentiation. Am J Dermatopathol 23:525–529

    CAS  PubMed  Article  Google Scholar 

  27. 27.

    Kirchmann TT, Prieto VG, Smoller BR (1994) CD34 staining pattern distinguishes basal cell carcinoma from trichoepithelioma. Arch Dermatol 130:589–592

    CAS  PubMed  Article  Google Scholar 

  28. 28.

    Kohchiyama A, Oka D, Ueki H (1987) Expression of human lymphocyte antigen (HLA)-DR on tumor cells in basal cell carcinoma. J Am Acad Dermatol 16:833–838

    CAS  PubMed  Article  Google Scholar 

  29. 29.

    Lang PG Jr, McKelvey AC, Nicholson JH (1987) Three-dimensional reconstruction of the superficial multicentric basal cell carcinoma using serial sections and a computer. Am J Dermatopathol 9:198–203

    PubMed  Article  Google Scholar 

  30. 30.

    LeBoit PE, Burg G, Weedon D et al (2006) Keratinocytic tumors. In: World Health Organization classification of tumours. Pathology and genetics of skin tumors. IARC Press, Lyon, S 10–19

  31. 31.

    Lei U, Masmas TN, Frentz G (2001) Occupational non-melanoma skin cancer. Acta Derm Venereol 81:415–417

    CAS  PubMed  Article  Google Scholar 

  32. 32.

    Leibovitch I, Huilgol SC, Selva D et al (2005) Basal cell carcinoma treated with Mohs surgery in Australia III. Perineural invasion. J Am Acad Dermatol 53:458–463

    PubMed  Article  Google Scholar 

  33. 33.

    Lichter MD, Karagas MR, Mott LA et al (2000) Therapeutic ionizing radiation and the incidence of basal cell carcinoma and squamous cell carcinoma. Arch Dermatol 136:1007–1011

    CAS  PubMed  Article  Google Scholar 

  34. 34.

    Lindboe CF, Løvdal L (2011) Epidermal basaloid cell hyperplasia overlying dermatofibromas. Am J Dermatopathol 33:52–55

    PubMed  Article  Google Scholar 

  35. 35.

    Markey AC, Lane EB, MacDonald DM et al (1992) Keratin expression in basal cell carcinomas. Br J Dermatol 126:154–160

    CAS  PubMed  Article  Google Scholar 

  36. 36.

    Miller SJ (1991) Biology of basal cell carcinoma (Part I). J Am Acad Dermatol 24:1–13

    CAS  PubMed  Article  Google Scholar 

  37. 37.

    Misago N, Mihara I, Ansai S et al (2002) Sebaceoma and related neoplasms with sebaceous differentiation. Am J Dermatopathol 24:294–304

    PubMed  Article  Google Scholar 

  38. 38.

    Misago N, Satoh T, Narisawa Y (2004) Basal cell carcinoma with ductal and glandular differentiation: a clinicopathological and immunohistochemical study of 10 cases. Eur J Dermatol 14:383–387

    PubMed  Google Scholar 

  39. 39.

    Mrak RE, Baker GF (1987) Granular basal cell carcinoma. J Cutan Pathol 14:37–42

    CAS  PubMed  Article  Google Scholar 

  40. 40.

    Nedved D, Tonkovic-Capin V, Hunt E et al (2014) Diagnostic concordance rates in the subtyping of basal cell carcinoma by different dermatopathologists. J Cutan Pathol 41:9–13

    PubMed  Article  Google Scholar 

  41. 41.

    Ochiai T, Suzuki H, Morioka S (1987) Basal cell epithelioma with giant tumor cells: light and electron microscopic study. J Cutan Pathol 14:242–247

    CAS  PubMed  Article  Google Scholar 

  42. 42.

    Oliver GF, Winkelmann RK (1988) Clear-cell basal cell carcinoma: histopathological, histochemical, and electron microscopic findings. J Cutan Pathol 15:404–408

    CAS  PubMed  Article  Google Scholar 

  43. 43.

    Parnes R, Safai B, Myskowski PL (1988) Basal cell carcinomas and lymphoma: biologic behavior and associated factors in sixty-three patients. J Am Acad Dermatol 19:1017–1023

    CAS  PubMed  Article  Google Scholar 

  44. 44.

    Plumb SJ, Argenyi ZB, Stone MS et al (2004) Cytokeratin 5/6 immunostaining in cutaneous adnexal neoplasms and metastatic adenocarcinoma. Am J Dermatopathol 26:447–451

    PubMed  Article  Google Scholar 

  45. 45.

    Reifenberger J (2004) Hereditary tumor syndromes. Cutaneous manifestations and molecular pathogenesis of Gorlin and Cowden syndromes. Hautarzt 55:942–951

    CAS  PubMed  Google Scholar 

  46. 46.

    Reifenberger J, Wolter M, Knobbe CB et al (2005) Somatic mutations in the PTCH, SMOH, SUFUH and TP53 genes in sporadic basal cell carcinomas. Br J Dermatol 152:43–51

    CAS  PubMed  Article  Google Scholar 

  47. 47.

    Requena L, Fariña MC, Robledo M et al (1999) Multiple hereditary infundibulocystic basal cell carcinomas: a genodermatosis different from nevoid basal cell carcinoma syndrome. Arch Dermatol 135:1227–1235

    CAS  PubMed  Article  Google Scholar 

  48. 48.

    Ríos-Martín JJ, Moreno-Ramírez D, González-Cámpora R (2012) What is the cause of retraction spaces associated with basal cell carcinoma? J Cutan Pathol 39:729–730

    PubMed  Article  Google Scholar 

  49. 49.

    Rowe DE, Carroll RJ, Day CL Jr (1989) Long-term recurrence rates in previously untreated (primary) basal cell carcinoma: implications for patient follow-up. J Dermatol Surg Oncol 15:315–328

    CAS  PubMed  Article  Google Scholar 

  50. 50.

    Schön MP, Reifenberger J, Von Schmiedeberg S et al (1999) Multiple basal cell carcinomas associated with hairy cell leukaemia. Br J Dermatol 140:150–153

    PubMed  Article  Google Scholar 

  51. 51.

    Sellheyer K (2011) Basal cell carcinoma and stem cell markers. Contribution to possible histogenesis? Hautarzt 62:119–127

    CAS  PubMed  Article  Google Scholar 

  52. 52.

    Sellheyer K, Nelson P, Kutzner H (2012) Fibroepithelioma of Pinkus is a true basal cell carcinoma developing in association with a newly identified tumour-specific type of epidermal hyperplasia. Br J Dermatol 166:88–97

    CAS  PubMed  Article  Google Scholar 

  53. 53.

    Sexton M, Jones DB, Maloney ME (1990) Histologic pattern analysis of basal cell carcinoma: study of a series of 1039 consecutive neoplasms. J Am Acad Dermatol 23:1118–1126

    CAS  PubMed  Article  Google Scholar 

  54. 54.

    Sloane JP (1977) The value of typing basal cell carcinomas in predicting recurrence after surgical excision. Br J Dermatol 96:127–133

    CAS  PubMed  Article  Google Scholar 

  55. 55.

    Von Domarus H, Stevens PJ (1984) Metastatic basal cell carcinoma. Report of five cases and review of 170 cases in the literature. J Am Acad Dermatol 10:1043–1060

    Article  Google Scholar 

  56. 56.

    Von Hoff DD, LoRusso PM, Rudin CM et al (2009) Inhibition of the hedgehog pathway in advanced basal cell carcinoma. N Engl J Med 361:1164–1172

    Article  Google Scholar 

  57. 57.

    Walsh N, Ackerman AB (1990) Infundibulocystic basal cell carcinoma: a newly described variant. Mod Pathol 3:599–608

    CAS  PubMed  Google Scholar 

  58. 58.

    Xie J, Murone M, Luoh SM et al (1998) Activating smoothened mutations in sporadic basal cell carcinoma. Nature 391:90–92

    CAS  PubMed  Article  Google Scholar 

  59. 59.

    Youssef KK, Van Keymeulen A, Lapouge G et al (2010) Identification of the cell lineage at the origin of basal cell carcinoma. Nat Cell Biol 12:299–305

    CAS  PubMed  Google Scholar 

  60. 60.

    Yu L, Galan A, McNiff JM (2009) Caveats in BerEP4 staining to differentiate basal and squamous cell carcinoma. J Cutan Pathol 36:1074–1076

    PubMed  Article  Google Scholar 

  61. 61.

    Ziegler A, Leffell DJ, Kunala S et al (1993) Mutation hotspots due to sunlight in the p53 gene of nonmelanoma skin cancers. Proc Natl Acad Sci U S A 90:4216–4220

    CAS  PubMed Central  PubMed  Article  Google Scholar 

Download references


Wir danken Dr. Arno Rütten, Dermatopathologie Friedrichshafen, für die freundliche Bereitstellung der Abbildungen 9 und 11.

Einhaltung ethischer Richtlinien

Interessenkonflikt. J. Schaller und J. Liersch geben an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

Author information



Corresponding author

Correspondence to Prof. Dr. J. Schaller.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Liersch, J., Schaller, J. Das Basalzellkarzinom und seine seltenen Formvarianten. Pathologe 35, 433–442 (2014). https://doi.org/10.1007/s00292-014-1930-2

Download citation


  • Einteilung
  • Nomenklatur
  • Histologisches Wachstumsmuster
  • Subtypisierung
  • Differenzialdiagnosen


  • Classification
  • Nomenclature
  • Histological growth pattern
  • Subtyping
  • Differential diagnoses