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Liver metastatic basaloid squamous cell carcinoma with negative expression of pancytokeratin: a case report and literature review

BACKGROUND: Basaloid squamous cell carcinoma (BSCC) is a rare subtype of squamous cell carcinoma with a high rate of distant metastasis. BSCC occurs most commonly in the esophagus, lungs, and head and neck. However, BSCC occurring in an atypical site without a known primary tumor and/or with the pre...

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Autores principales: Liu, Linxiu, Xue, Xuemin, Xue, Liyan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6729002/
https://www.ncbi.nlm.nih.gov/pubmed/31488173
http://dx.doi.org/10.1186/s13000-019-0881-6
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author Liu, Linxiu
Xue, Xuemin
Xue, Liyan
author_facet Liu, Linxiu
Xue, Xuemin
Xue, Liyan
author_sort Liu, Linxiu
collection PubMed
description BACKGROUND: Basaloid squamous cell carcinoma (BSCC) is a rare subtype of squamous cell carcinoma with a high rate of distant metastasis. BSCC occurs most commonly in the esophagus, lungs, and head and neck. However, BSCC occurring in an atypical site without a known primary tumor and/or with the presence of atypical immunohistochemical features can result in delayed diagnosis or misdiagnosis. CASE PRESENTATION: Here, we report a case of a 67-year-old man with liver metastatic BSCC with negative pancytokeratin (AE1/AE3) expression. He presented with a chief complaint of epigastric discomfort. Imaging examination revealed a subcapsular mass in the right anterior lobe of the liver. Then, the patient underwent an irregular right hepatectomy. Grossly, the mass was gray, with a size of 7 × 7 × 4 cm. Microscopically, the mass comprised epithelioid tumor cells with both solid and pseudoadenoid structures, accompanied by necrosis. Immunohistochemical staining showed that the tumor cells were negative for AE1/AE3, CK18, CK7, CK19, Hepatocyte Paraffin-1, Glypican-3, Arginase-1, CD56, Chromogranin A, Synaptophysin, Vimentin, and Carcinoembryonic antigen. The Ki-67 index was 80%.The mass was diagnosed as a malignant tumor but could not be classified further. One month after surgery, the patient’s reexamination revealed esophageal tumor, and biopsy revealed BSCC. The slides of the liver tumor were reviewed, and the morphology was similar to that of the esophageal tumor. Moreover, supplementary immunohistochemical staining of liver tumor indicated p63 and p40 were strongly positive, that confirmed the liver tumor was metastatic BSCC. Previous studies have reported that 3.7% of esophageal BSCCs did not express AE1/AE3. CONCLUSION: When a malignant tumor comprises epithelioid cells with solid and/or pseudoadenoid structures, but not adenocarcinoma or neuroendocrine carcinoma, even if the tumor cells are negative or weakly positive for AE1/AE3, we should consider BSCC. For a definite diagnosis, immunohistochemical staining for squamous cell carcinoma markers, including p63 and p40, and examination of common primary sites of BSCC should be performed.
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spelling pubmed-67290022019-09-12 Liver metastatic basaloid squamous cell carcinoma with negative expression of pancytokeratin: a case report and literature review Liu, Linxiu Xue, Xuemin Xue, Liyan Diagn Pathol Case Report BACKGROUND: Basaloid squamous cell carcinoma (BSCC) is a rare subtype of squamous cell carcinoma with a high rate of distant metastasis. BSCC occurs most commonly in the esophagus, lungs, and head and neck. However, BSCC occurring in an atypical site without a known primary tumor and/or with the presence of atypical immunohistochemical features can result in delayed diagnosis or misdiagnosis. CASE PRESENTATION: Here, we report a case of a 67-year-old man with liver metastatic BSCC with negative pancytokeratin (AE1/AE3) expression. He presented with a chief complaint of epigastric discomfort. Imaging examination revealed a subcapsular mass in the right anterior lobe of the liver. Then, the patient underwent an irregular right hepatectomy. Grossly, the mass was gray, with a size of 7 × 7 × 4 cm. Microscopically, the mass comprised epithelioid tumor cells with both solid and pseudoadenoid structures, accompanied by necrosis. Immunohistochemical staining showed that the tumor cells were negative for AE1/AE3, CK18, CK7, CK19, Hepatocyte Paraffin-1, Glypican-3, Arginase-1, CD56, Chromogranin A, Synaptophysin, Vimentin, and Carcinoembryonic antigen. The Ki-67 index was 80%.The mass was diagnosed as a malignant tumor but could not be classified further. One month after surgery, the patient’s reexamination revealed esophageal tumor, and biopsy revealed BSCC. The slides of the liver tumor were reviewed, and the morphology was similar to that of the esophageal tumor. Moreover, supplementary immunohistochemical staining of liver tumor indicated p63 and p40 were strongly positive, that confirmed the liver tumor was metastatic BSCC. Previous studies have reported that 3.7% of esophageal BSCCs did not express AE1/AE3. CONCLUSION: When a malignant tumor comprises epithelioid cells with solid and/or pseudoadenoid structures, but not adenocarcinoma or neuroendocrine carcinoma, even if the tumor cells are negative or weakly positive for AE1/AE3, we should consider BSCC. For a definite diagnosis, immunohistochemical staining for squamous cell carcinoma markers, including p63 and p40, and examination of common primary sites of BSCC should be performed. BioMed Central 2019-09-06 /pmc/articles/PMC6729002/ /pubmed/31488173 http://dx.doi.org/10.1186/s13000-019-0881-6 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Case Report
Liu, Linxiu
Xue, Xuemin
Xue, Liyan
Liver metastatic basaloid squamous cell carcinoma with negative expression of pancytokeratin: a case report and literature review
title Liver metastatic basaloid squamous cell carcinoma with negative expression of pancytokeratin: a case report and literature review
title_full Liver metastatic basaloid squamous cell carcinoma with negative expression of pancytokeratin: a case report and literature review
title_fullStr Liver metastatic basaloid squamous cell carcinoma with negative expression of pancytokeratin: a case report and literature review
title_full_unstemmed Liver metastatic basaloid squamous cell carcinoma with negative expression of pancytokeratin: a case report and literature review
title_short Liver metastatic basaloid squamous cell carcinoma with negative expression of pancytokeratin: a case report and literature review
title_sort liver metastatic basaloid squamous cell carcinoma with negative expression of pancytokeratin: a case report and literature review
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6729002/
https://www.ncbi.nlm.nih.gov/pubmed/31488173
http://dx.doi.org/10.1186/s13000-019-0881-6
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AT xueliyan livermetastaticbasaloidsquamouscellcarcinomawithnegativeexpressionofpancytokeratinacasereportandliteraturereview