Basosquamous Carcinoma Involving the Anterior Skull Base: A Neglected Tumor Treated Using Intraoperative Navigation as a Guide to Achieve Safe Resection Margins

Dalhousie University, Department of Oral and Maxillofacial Surgery, Halifax, Nova Scotia, Canada.
Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons (Impact Factor: 1.43). 10/2010; 69(1):230-6. DOI: 10.1016/j.joms.2010.06.206
Source: PubMed


Basosquamous carcinoma (BSC) or metatypical carcinoma is a rare and controversial form of basal cell carcinoma (BCC) that was first described by MacCormac in 1910. Numerous theories have been described in the literature regarding its origin but it is generally accepted as a variant of BCC that differentiates into squamous cell carcinoma (SCC). At present, it has an unsatisfactorily established phenotype but is considered to behave more like an SCC than a BCC. A reflection of this fact is its more aggressive nature with a significantly increased incidence of local and distant metastasis. It must be distinguished histologically from so-called "collision" tumors, which represent SCC and BCC arising as separate entities in the same area. We present a unique case of a neglected, large, and locally advanced case of BCC originating from the nose, but extending into the paranasal sinuses, orbit, and anterior skull base, that was treated with en bloc surgical resection using intraoperative navigation to assist in treatment planning and margin clearance.

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    • "It is very important to identify prognostic indicators of recurrence which should include: positive surgical margins, perineural or lymphatic invasion, bone involvement and size greater than of 3 cm in diameter. A close radiological and clinical follow-up should be mandatory in presence of one of these factors [17] but it appears necessary also in patients with a positive diagnosis of BSC even in absence of indicators. In addition we think that more attention should be paid for all tumours diagnosed as BCC but with aggressive histological features and involvement of deep structures (bone, nerves, blood and lymphatic vessels and others). "
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