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Indian Journal of Pathology: Research and Practice

Volume  13, Issue 2, April - June 2024, Pages 61-66
 

Review Article

Basal Cell Carcinoma Mixed Histological Subtype: Case Report and Review of Literature

Sunil V Jagtap1, Shubham S Jagtap2, Ramnik Singh3, Devika Borade4, Harshkumar Machhi5

1Professor, Department of   Pathology, 2Resident, Department of Medicine,  3,4,5Resident, Department of Pathology, Krishna
Vishwa Vidyapeeth (Deemed to be University), Krishna Institute of Medical Sciences, Karad 415539, Maharashtra, India
 

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DOI: http://dx.doi.org/10.21088/ijprp.2278.148X.13224.3

Abstract

Background: Basal cell carcinomais a slow growing malignant cutaneous non melanocytic  tumor that is locally aggressive but it rarely metastasizes. Case of 61 year male presented to the  outpatient department with a round, nonhealing ulcer with hyperpigmentation, measuring  2.5x2.1x0.8cm over the right side of face, 1.8 cm below the right eye region for the last 1.5
years. Patient had history of swelling at same site 1.5 year back, as small nodular lesion which  was excised. The general physical and systemic examinations were normal. The lesion was  surgically excised with wide margins. The specimen on gross measured 2.3x2.1x0.6cm, firm,  grey brown to black colored hyperpigmented with rolled out margins and central ulceration  measuring 1.6x1.4x0.6cm. Cut section was grey white, nodular with blackish pigmentations.  On microscopic examination showed a circumscribed nodular lesion composed of neoplastic cells arranged in large basaloid lobules with peripheral nuclear palisadations. The neoplastic basaloid cells with scant cytoplasm and hyperchromatic nuclei were seen. The stroma was  fibromyxoid with focal inflammation. The surface ulceration was noted. The nodules are  variable size of more than 0.3cm diameter. Tumor showed  pidermal attachment. In areas the   reticulate, pseudoglandular pattern of basaloid neoplastic cells were noted with a mucinous
stroma. Focal areas of colonization of tumor's complexes with melanocytes and stromal  melanophages pigmentation was noted. The tumor showed 0.5cm depth of invasion. The   mitotic activity was low, minimal atypia and apoptosis were noted. The lymphovascular, perineural invasion was absent. All peripheral and deep surgical margins were free from tumor. On histopthological findings reported as Basal cell carcinoma-nodular, adenoid cystic  and pigmented: mixed histological subtype over face. The patient was kept on regular follow  up. There was no evidence of recurrence   or any metastasis. Conclusion: We present this rare case
of Basal cell carcinoma-nodular, adenoid  cystic and pigmented: mixed histological  subtype for its clinical and morphological
findings. The pathological diagnosis and classification of BCC are essential for the evaluation of the tumour type, its biological behaviour, risk assessment of the recurrence and treatment.
 


Keywords : Basal cell carcinoma; Adenoid; Pigmented BBC; Mixed histological subtype.
Corresponding Author : Sunil Vitthalrao Jagtap