Basal cell carcinoma‑not always the ‘good guy’: Case report of a life‑threatening basosquamous carcinoma and review of the literature

Abstract

Cutaneous basosquamous carcinoma is a variant of basal cell carcinoma that is characterized by histopathological features of both basal and squamous cell carcinoma. Due to its local invasiveness, high frequency of recurrence, and its metastatic potential, it is considered to be one of the most aggressive subtypes of basal cell carcinoma. We present the case of an 81-year-old male who was admitted to the hospital with incessant hemorrhage arising from a cutaneous tumor that later proved to be a basosquamous carcinoma. Due to the COVID-19 pandemic at the time, the patient did not seek medical attention as soon as the bleeding was observed, although he did present when the symptom increased in intensity and became incessant. To our knowledge, this is the first case report of a cutaneous basosquamous carcinoma that presents with a massive life-threatening hemorrhage tumor, thus endangering the patient's life. The clinical and histopathological features, the behavior and the treatment of cutaneous basosquamous carcinoma are further reviewed in this article.

Metastasis of a basosquamous carcinoma arising in a nevus sebaceus

“…BSC is considered an aggressive type of BCC with squamous differentiation. Although it is rare, accounting for 1.2%–2.7% of all non‐melanoma skin tumors, it deserves clinical attention because of its high recurrence rate, potential for metastasis, and poor prognosis 14,15 . Previous studies have reported a metastasis rate of 5%–8.4% and an estimated recurrence rate of 4.5% for BSC compared to conventional BCC, which has a metastasis rate of less than 0.1% 14,15 .…”

“…Although it is rare, accounting for 1.2%–2.7% of all non‐melanoma skin tumors, it deserves clinical attention because of its high recurrence rate, potential for metastasis, and poor prognosis 14,15 . Previous studies have reported a metastasis rate of 5%–8.4% and an estimated recurrence rate of 4.5% for BSC compared to conventional BCC, which has a metastasis rate of less than 0.1% 14,15 . The median survival of patients with BSC metastases is 6.5 years, with an overall 5‐year survival rate of approximately 54% 15 .…”

“…14,15 Previous studies have reported a metastasis rate of 5%-8.4% and an estimated recurrence rate of 4.5% for BSC compared to conventional BCC, which has a metastasis rate of less than 0.1%. 14,15 The median survival of patients with BSC metastases is 6.5 years, with an overall 5-year survival rate of approximately 54%. 15 The clinical presentation of BSC is not significantly different from that of other types of BCC, both of which most often occur in sun-exposed areas.…”

“…14,15 The median survival of patients with BSC metastases is 6.5 years, with an overall 5-year survival rate of approximately 54%. 15 The clinical presentation of BSC is not significantly different from that of other types of BCC, both of which most often occur in sun-exposed areas. 16 Ulceration and pink color may be an indication of BSC.…”

Supraorbital Basosquamous Carcinoma Treated with Cemiplimab Followed by Sonidegib: A Case Report and Review of the Literature

“…BSC accounts for approximately 1% of nonmelanoma skin cancers and frequently occurs in male patients older than 70 years [24]. Pathogenesis is controversial; the origin of BSCs has not yet been fully elucidated, but a high frequency of mutations in the HH pathway has been observed [25].…”