Basal Cell Carcinoma with Sebaceous Differentiation: A Case Report and Review of Literature

Abstract

Summary: We report a very rare type of tumor in the left nasal ala in an elderly patient. An 81-year-old Saudi woman known to have hypertension, osteoporosis, and rheumatoid disease (who had been compliant to her medications) presented with a 0.5-cm fixed, firm, round well-defined nodule on the left ala of the nose (with crusting, erosion, and telangiectasia of the overlying skin), whose size had been gradually increasing for 2 years. The patient underwent excisional biopsy, and the specimen was sent for a histopathologic analysis. Macroscopic examination showed a round tan-white homogenous nodule, measuring 0.6 × 0.5 × 0.5 cm3. Microscopic examination revealed a fairly circumscribed unencapsulated dermal lesion, featuring basaloid cells with peripheral palisading, and focal stromal clefting. The final diagnosis of basal cell carcinoma with sebaceous differentiation was made. The patient was managed with Mohs surgery with clear margins, and full-thickness skin graft was done. Four months after surgery, the patient had a recurrence, which was managed with a surgical excision (with 4-mm margin) and covered by a full-thickness skin graft.

Basal cell carcinoma: Comprehensive clinical and histopathological aspects, novel imaging tools and therapeutic approaches (Review)

“…BCC with adnexal differentiation defines a subtype of BCC which is frequently found in the skin around the eyes, exhibiting differentiation towards follicular, eccrine, apocrine or sebaceous glands. Matrical differentiation in BCC is revealed by the presence of shadow cells; the infundibulocystic variant is characterized by the presence of small infundibular cyst-like spaces inside the tumor nodules; mature sebocytes can be found in BCC with sebaceous differentiation, while ductal structures, such as those found in eccrine and apocrine glands (and decapitation secretion in apocrine differentiation) are found in BCC with differentiation towards eccrine or apocrine sweat glands ( 1 , 5 , 38 ).…”

CD56 and smooth muscle actin immunoreactivity in basal cell carcinomas: Are they indicators of differentiation or do they hold a diagnostic use?

“…The possible pluripotent stem cell origin of BCC is considered to be the main reason that pathologists encounter various morphological forms of this tumor. Cases showing morphologically detectable differentiation such as keratotic, eccrine, apocrine, matrical, sebaceous, and follicular and less frequent myoepithelial, neuronal, and neuroendocrine differentiation detected by immunohistochemical markers have been reported 6–12 …”

“…neuroendocrine differentiation detected by immunohistochemical markers have been reported. [6][7][8][9][10][11][12] In the present study, we aimed to evaluate the expression of some neuroendocrine and smooth muscle markers of differentiation in BCC cases. Moreover, we evaluated the relationship between the results obtained and histopathologic subtypes and the risk of recurrence.…”

Primary Sebaceous Carcinoma of Esophagus: The First Case Report and Literature Review

“…BCC is the most frequent histopathological diagnosis obtained in the rst assessment of SC cases. When accompanying with sebaceous differentiation (BCCSD), the situation will be more complex [42][43][44].…”