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Basal Cell Carcinoma Associated with Secondary Localized Cutaneous Amyloid Deposits: Case Report and Review

Amyloid deposition has been observed in tissue specimens of basal cell carcinomas. A 68-year-old man with a nodular basal cell carcinoma on his left arm near the elbow is described; microscopic evaluation of the biopsy tissue specimen shows not only nodular aggregates and strands of atypical basaloi...

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Autor principal: Cohen, Philip R
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6420332/
https://www.ncbi.nlm.nih.gov/pubmed/30899630
http://dx.doi.org/10.7759/cureus.3879
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author Cohen, Philip R
author_facet Cohen, Philip R
author_sort Cohen, Philip R
collection PubMed
description Amyloid deposition has been observed in tissue specimens of basal cell carcinomas. A 68-year-old man with a nodular basal cell carcinoma on his left arm near the elbow is described; microscopic evaluation of the biopsy tissue specimen shows not only nodular aggregates and strands of atypical basaloid tumor cells but also marked deposition of amorphous amyloid material in the stroma between the aggregates of basal cell carcinoma. Including the man in this report, there are additional individual descriptions of patients whose basal cell carcinomas have amyloid deposits in the adjacent stroma or within the tumor aggregates or both. In addition, several retrospective pathology investigations have evaluated the features of this phenomenon. The incidence of basal cell carcinoma with amyloid deposition, in the English literature, ranges from 11% to 75%; however, it is possible that staining technique or tumor subtype or quantity of amyloid present may account for the lower detection of amyloid observed by some of the researchers. Amyloid in basal cell carcinoma specimens was observed to be present more frequently in older patients who had tumors with less aggressive histology patterns. Nodular basal cell carcinoma was the most common subtype of tumor with amyloid deposits whereas superficial basal cell carcinoma was the least frequent subtype. The amyloid deposits were usually identified on hematoxylin and eosin-stained sections and confirmed by using stains that allowed for easier visualization of the amyloid. The amyloid deposits were most commonly located in the stroma between the tumor aggregates; other locations included the papillary dermis above the carcinoma, the dermis at the advancing edge of the tumor and within the aggregates of basal cell carcinoma. Many of the basal cell carcinomas with amyloid deposits, similar to the reported patient, also contained solar elastosis. The origin of the amyloid deposition in these tumors is secondary amyloid AA protein from keratin derived from the epithelial cells overlying the basal cell carcinomas. The presence of amyloid deposition does not alter the management of these basal cell carcinomas; the treatment of the tumor is the same as when the basal cell carcinoma does not contain amyloid deposition.
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spelling pubmed-64203322019-03-21 Basal Cell Carcinoma Associated with Secondary Localized Cutaneous Amyloid Deposits: Case Report and Review Cohen, Philip R Cureus Dermatology Amyloid deposition has been observed in tissue specimens of basal cell carcinomas. A 68-year-old man with a nodular basal cell carcinoma on his left arm near the elbow is described; microscopic evaluation of the biopsy tissue specimen shows not only nodular aggregates and strands of atypical basaloid tumor cells but also marked deposition of amorphous amyloid material in the stroma between the aggregates of basal cell carcinoma. Including the man in this report, there are additional individual descriptions of patients whose basal cell carcinomas have amyloid deposits in the adjacent stroma or within the tumor aggregates or both. In addition, several retrospective pathology investigations have evaluated the features of this phenomenon. The incidence of basal cell carcinoma with amyloid deposition, in the English literature, ranges from 11% to 75%; however, it is possible that staining technique or tumor subtype or quantity of amyloid present may account for the lower detection of amyloid observed by some of the researchers. Amyloid in basal cell carcinoma specimens was observed to be present more frequently in older patients who had tumors with less aggressive histology patterns. Nodular basal cell carcinoma was the most common subtype of tumor with amyloid deposits whereas superficial basal cell carcinoma was the least frequent subtype. The amyloid deposits were usually identified on hematoxylin and eosin-stained sections and confirmed by using stains that allowed for easier visualization of the amyloid. The amyloid deposits were most commonly located in the stroma between the tumor aggregates; other locations included the papillary dermis above the carcinoma, the dermis at the advancing edge of the tumor and within the aggregates of basal cell carcinoma. Many of the basal cell carcinomas with amyloid deposits, similar to the reported patient, also contained solar elastosis. The origin of the amyloid deposition in these tumors is secondary amyloid AA protein from keratin derived from the epithelial cells overlying the basal cell carcinomas. The presence of amyloid deposition does not alter the management of these basal cell carcinomas; the treatment of the tumor is the same as when the basal cell carcinoma does not contain amyloid deposition. Cureus 2019-01-14 /pmc/articles/PMC6420332/ /pubmed/30899630 http://dx.doi.org/10.7759/cureus.3879 Text en Copyright © 2019, Cohen et al. http://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Dermatology
Cohen, Philip R
Basal Cell Carcinoma Associated with Secondary Localized Cutaneous Amyloid Deposits: Case Report and Review
title Basal Cell Carcinoma Associated with Secondary Localized Cutaneous Amyloid Deposits: Case Report and Review
title_full Basal Cell Carcinoma Associated with Secondary Localized Cutaneous Amyloid Deposits: Case Report and Review
title_fullStr Basal Cell Carcinoma Associated with Secondary Localized Cutaneous Amyloid Deposits: Case Report and Review
title_full_unstemmed Basal Cell Carcinoma Associated with Secondary Localized Cutaneous Amyloid Deposits: Case Report and Review
title_short Basal Cell Carcinoma Associated with Secondary Localized Cutaneous Amyloid Deposits: Case Report and Review
title_sort basal cell carcinoma associated with secondary localized cutaneous amyloid deposits: case report and review
topic Dermatology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6420332/
https://www.ncbi.nlm.nih.gov/pubmed/30899630
http://dx.doi.org/10.7759/cureus.3879
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