Basosquamous carcinoma and keratotic BCC, how to define?
Several histopathological types of BCC have been described in dermatopathology text books. However basosquamous carcinoma and keratotic BCC have confusing definitions that vary in different text books and sometimes I find this discrepancy irritating!!!
According to Weedon's skin pathology, a keratotic BCC is a BCC in which the islands show squamous differentiation and central keratinization, while in McKee's pathology of the skin, it is a BCC which contain horn cysts and in some cases may mimic a trichoepithelioma. This definition applies in Weedon's skin pathology to infundibulocystic BCC!!
On the other hand, basosquamous carcinoma according to Weedon's skin pathology is a BCC with three types of cells: basaloid, squamoid and metatypical (large pale cells), while in McKee's pathology of the skin, it is a BCC with areas of squamous differentiation and is also described as metatypical BCC.
I know that basosquamous carcinoma carries a risk of distant metastasis, hence I feel it is important to be accurate in defining a lesion as basosquamous carcinoma. But how to manage this without the presence of a unified definition in dermatopathology text books??
From my own interpretation of illustrations and photos in different textbooks, I came up to this conclusion which I am using in my reporting that I want to share with you and I want you to tell me: am I understanding this right or wrong? A tumor composed of simultaneous (biphasic) existence of areas of a typical BCC and areas of a typical SCC will be called basosquamous carcinoma. On the other hand, a BCC in which some of the islands show squamoid differentiation and central keratinization will be called a keratotic BCC. Am I on the right track???
According to Weedon's skin pathology, a keratotic BCC is a BCC in which the islands show squamous differentiation and central keratinization, while in McKee's pathology of the skin, it is a BCC which contain horn cysts and in some cases may mimic a trichoepithelioma. This definition applies in Weedon's skin pathology to infundibulocystic BCC!!
On the other hand, basosquamous carcinoma according to Weedon's skin pathology is a BCC with three types of cells: basaloid, squamoid and metatypical (large pale cells), while in McKee's pathology of the skin, it is a BCC with areas of squamous differentiation and is also described as metatypical BCC.
I know that basosquamous carcinoma carries a risk of distant metastasis, hence I feel it is important to be accurate in defining a lesion as basosquamous carcinoma. But how to manage this without the presence of a unified definition in dermatopathology text books??
From my own interpretation of illustrations and photos in different textbooks, I came up to this conclusion which I am using in my reporting that I want to share with you and I want you to tell me: am I understanding this right or wrong? A tumor composed of simultaneous (biphasic) existence of areas of a typical BCC and areas of a typical SCC will be called basosquamous carcinoma. On the other hand, a BCC in which some of the islands show squamoid differentiation and central keratinization will be called a keratotic BCC. Am I on the right track???
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