Skip to main content
SpringerLink
Log in

How to spot a basosquamous carcinoma: a study on demographics, clinical-dermatoscopic features and histopathological correlations

  • Clinical report
  • Published:
European Journal of Dermatology

Abstract

Background

Basosquamous carcinoma (BSC) is a relatively rare type of neoplasm originating from basal cell carcinoma with features of squamous differentiation. BSC has an aggressive local behaviour with a tendency for recurrence and a less frequent metastatic potential

Objectives

The primary objective was to describe the dermatoscopic features of the tumour. Secondary goals were to detect the morphological features of the tumour along with patients’ characteristics and to evaluate possible dermatoscopic and histopathological correlations

Materials & Methods

Twenty-two patients with 25 BSCs were enrolled. All tumours were surgically excised and diagnosis was based on histopathology. Clinical and dermatoscopic images were evaluated by two investigators based on pre-defined criteria, and a statistical analysis was performed

Results

The median age of the patients was 78 years old (range: 52–88) and the male/female ratio was 2.14. All patients reported history of either occupational (50%) or recreational (50%) intensive sun exposure and 72.73% had signs of actinic keratosis. The most common anatomical site of the tumours was the head/neck area (72%). Clinically, nodular (64%), ulcerated (88%) and non-pigmented (76%) lesions prevailed. Dermatoscopically, 92% had prominent vasculature and monomorphous arborizing vessels with a diffuse arrangement, representing the most frequently observed type. Ulceration (88%), SCC dermatoscopic criteria (56%), white strands/blotches (56%) and features of pigmentation (40%) were also detected

Conclusion

We suggest that the most common prototype of BSC is an ulcerated, facial nodule in elderly males with photo-damaged skin, dermatoscopically displaying combined features of mostly nodular BCC and, to a less extent, SCC

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

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Elder DJ, Massi S, Scolyer RA, Willemze R. WHO classification of skin tumors. Lyon: IARC, 2018.

    Google Scholar 

  2. Leibovitch I, Huilgol SC, Selva D, et al. Basosquamous carcinoma: treatment with Mohs micrographic surgery. Cancer 2005; 104: 170–5.

    Article  Google Scholar 

  3. Maloney ML. What is basosquamous carcinoma? Dermatol Surg 2000; 26: 505–6.

    Article  CAS  Google Scholar 

  4. Peris K, Fargnoli MC, Garbe C, et al. Diagnosis and treatment of basal cell carcinoma: European consensus-based interdisciplinary guidelines. Eur J Cancer 2019; 118: 10–34.

    Article  CAS  Google Scholar 

  5. Cameron MC, Lee E, Hibler BP, et al. Basal cell carcinoma. Contemporary approaches to diagnosis, treatment, and prevention. J Am Acad Dermatol 2019; 80: 321–40.

    Article  Google Scholar 

  6. Tan KZ, Rieger KE, Sarin KY. Basosquamous carcinoma: controversy, advances and future directions. Dermatol Surg 2017; 43: 23–31.

    Article  CAS  Google Scholar 

  7. Volkenstein S, Wohlschlaeger J, Liebau J, et al. Basosquamous carcinoma-a rare but aggressive skin malignancy. J Plast Reconstr Aesth Surg 2010; 63: 304–6.

    Article  Google Scholar 

  8. Kittler H, Rosendahl C, Cameron A, Tschandl P. Dermatoscopy: an algorithmic method based on pattern analysis. Vienna: Facultas.wuv Universitäts, 2016.

    Google Scholar 

  9. Lallas A, Apalla Z, Argenziano G, et al. The dermatoscopic universe of basal cell carcinoma. Dermatol Pract Concept 2013; 4: 11–24.

    Google Scholar 

  10. Giacomel J, Zalaudek I. Pink lesions. Dermatol Clin 2013; 31: 649–78.

    Article  CAS  Google Scholar 

  11. Lallas A, Apalla Z, Ioannides D, et al. Dermoscopy in the diagnosis and management of basal cell carcinoma. Future Oncol 2015;11:2975–84.

    Article  CAS  Google Scholar 

  12. Suppa M, Micantonio T, Di Stefano A, et al. Dermoscopic variability of basal cell carcinoma according to clinical type and anatomic location. J Eur Acad Dermatol Venereol 2015; 29: 1732–41.

    Article  CAS  Google Scholar 

  13. Yélamos O, Braun RP, Liopyris K, et al. Dermoscopy and dermatopathology correlates of cutaneous neoplasms. J Am Acad Dermatol 2019; 80: 341–64.

    Article  Google Scholar 

  14. Reiter O, Mimouni I, Gdalevich M, et al. The diagnostic accuracy of dermoscopy for basal cell carcinoma: a systematic review and metaanalysis. J Am Acad Dermatol 2019; 80: 1380–8.

    Article  Google Scholar 

  15. Giacomel J, Lallas A, Argenziano G, et al. Dermoscopy of basosquamous carcinoma. Br J Dermatol 2013; 169: 358–64.

    Article  CAS  Google Scholar 

  16. Akay BN, Saral S, Heper AO, Erdem C, Rosendahl C. Basosquamous carcinoma: dermoscopic clues to diagnosis. J Dermatol 2017; 44: 127–34.

    Article  CAS  Google Scholar 

  17. Cunceen TS, Yong JL, Benger R. Lung metastases in a case of metatypical basal cell carcinoma of the eyelid: an illustrative case and literature review to heighten vigilance of its metastatic potential. Clin Exp Opthalmol 2008; 36: 475–7.

    Article  Google Scholar 

  18. Wermker K, Roknic N, Goessling K, Klein M, Schulze HJ, Hallermann C. Basosquamous carcinoma of the head and neck: clinical and histologic characteristics and their impact on disease progression. Neoplasia 2015;17:301–5.

    Article  CAS  Google Scholar 

  19. Oldbury J, Wain R, Abas S, Dobson C, Iyer S. Basosquamous carcinoma: a single centre clinicopathological evaluation and proposal of an evidence-based protocol. J Skin Cancer 2018; 2018: 6061395.

    Article  Google Scholar 

  20. Tarallo M, Cigna E, Frati R, et al. Metatypical basal cell carcinoma: a clinical review. J Exp Clin Cancer Res 2008; 27: 65.

    Article  Google Scholar 

  21. Garcia C, Poletti E, Neil Crowson A. Basosquamous carcinoma. J Am Acad Dermatol 2009; 60: 137–43.

    Article  Google Scholar 

  22. Cigna E, Tarallo M, Servillo S, Piperno A, Scuderi N. Metatypical carcinoma of the head: a review of 312 cases. Eur Rev Med Pharmacol Sci 2012;16:1915–8.

    CAS  PubMed  Google Scholar 

  23. Moon HR, Park TJ, Ro KW, et al. Pigmentation of basal cell carcinoma is inversely associated with tumor aggressiveness in Asian patients. J Am Acad Dermatol 2019; 80: 1755–7.

    Article  Google Scholar 

  24. Conforti C, Pizzichetta MA, Vichi S, et al. Sclerodermiform basal cell carcinomas vs. other histotypes: analysis of specific demographic, clinical and dermatoscopic features. J Eur Acad Dermatol Venereol 2021; 35: 79–87.

    Article  CAS  Google Scholar 

  25. Pampena R, Parisi G, Benati M, et al. Clinical and dermoscopic factors for the identification of aggressive histologic subtypes of basal cell carcinoma. Front Oncol 2021; 10: 630458.

    Article  Google Scholar 

  26. Navarette-Dechent C, Bajaj S, Marchetti M, Rabinovitz H, Dusza S, Marghoob A. Association of shiny white blotches and strands with nonpigmented basal cell carcinoma. JAMA Dermatol 2016; 152: 546–52.

    Article  Google Scholar 

  27. Navarette-Dechent C, Liopyris K, Rishpon A, et al. Association of multiple aggregated yellow-white globules with nonpigmented Basal Cell Carcinoma. JAMA Dermatol 2020; 156: 882–90.

    Article  Google Scholar 

  28. Balagula Y, Braun RP, Rabinovitz HS, et al. The significance of crystalline/chrysalis structures in the diagnosis of melanocytic and nonmelanocytic lesions. J Am Acad Dermatol 2012; 67: 194e1–8.

    Article  Google Scholar 

  29. Rosendahl C, Cameron A, Argenziano G, Zalaudek I, Tschandl P, Kittler H. Dermoscopy of squamous cell carcinoma and keratoacanthoma. Arch Dermatol 2012; 148: 1386–92.

    Article  Google Scholar 

Download references

Acknowledgements and disclosures

Acknowledgements: the patients in this manuscript have given written informed consent to publication of their case details.

Funding sources: none.

Conflicts of interest: none.

Author information

Authors and Affiliations

  1. 2nd Department of Dermatology-Venereology, “Attikon” General University Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece

    Dimitrios Sgouros, Melpomeni Theofili, Georgios Kokkalis, Eftichia Kitsiou, Antonios Kanelleas & Alexander Katoulis

  2. State Clinic of Dermatology, Hospital for Skin and Venereal Diseases, Thessaloniki, Greece

    Zoe Apalla

  3. 2nd Department of Pathology, “Attikon” General University Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece

    Vasileia Damaskou & Ioannis Panayiotides

  4. First Department of Dermatology, Aristotle University, Thessaloniki, Greece

    Aimilios Lallas

  5. 1st Department of Dermatology-Venereology, Andreas Sygros Hospital, National and Kapodistrian University of Athens School of Medicine, Athens, Greece

    Alexander Stratigos & Dimitrios Rigopoulos

  6. Pathology Laboratory, Hippokratio General Hospital, Thessaloniki, Greece

    Christina Nikolaidou

  7. Department of Biomedical Sciences, International Hellenic University, Alexandrian Campus, Sindos, Thessaloniki, Greece

    Mattheos Bobos

Authors
  1. Dimitrios Sgouros
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Zoe Apalla
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Melpomeni Theofili
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Vasileia Damaskou
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Georgios Kokkalis
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Eftichia Kitsiou
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Aimilios Lallas
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Antonios Kanelleas
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Alexander Stratigos
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Christina Nikolaidou
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Mattheos Bobos
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Ioannis Panayiotides
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Dimitrios Rigopoulos
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Alexander Katoulis
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Dimitrios Sgouros.

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sgouros, D., Apalla, Z., Theofili, M. et al. How to spot a basosquamous carcinoma: a study on demographics, clinical-dermatoscopic features and histopathological correlations. Eur J Dermatol 31, 779–784 (2021). https://doi.org/10.1684/ejd.2021.4178

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1684/ejd.2021.4178

Key words

Search

Navigation