Colliding, colonizing or combining? Four cases illustrating the unique challenges presented by melanoma arising in conjunction with basal cell carcinoma

Citations Over TimeTop 23% of 2018 papers

Abstract

Biphasic lesions comprised of melanocytic and epithelial components are rare entities believed to arise either as a collision of 2 histologically distinct lesions in the same anatomic location or as a singular progenitor tumor differentiating along 2 differing lineages. Regardless of mechanism of origin, these tumors present unique challenges in pathologic interpretation and in determining appropriate measurements, which assigns subsequent prognosis to the patient. We present 4 tumors of melanoma co-existing with basal cell carcinoma (BCC) and discuss relevant literature regarding these biphasic entities. Patients consisted of 3 males and 1 female, ranging in age from 62 to 93, with lesions located on the shoulder, frontal scalp, forearm and nose. Three of 4 lesions showed melanoma cells limited to BCC tumor lobules, without evidence of direct dermal invasion by melanoma cells, raising the question of whether or not these tumors should be classified as in situ or invasive melanoma. These cases highlight the complexity that such lesions pose to dermatopathologists, in terms of their uncertain origin and variable microscopic appearance. In the absence of data regarding outcomes for these tumors (given their rarity), it is important to utilize a case-by-case approach, with careful clinical correlation and appropriate use of ancillary techniques.

Related Papers

• Reconstructive rhinoplasty in cases with basal cell carcinoma of the nose.(2012)
• The use of paramedian forehead flap reconstruction after wide excision of basal cell carcinoma of the nose.(2008)
• Combination of advancement and rotation flap for large defect closure of basal cell carcinoma on the cheek, lip and nose(2020)
• → Basal cell carcinoma resected tumor with external nose reconstruction simultaneously.(1993)
• → Surgical excision with paramedian forehead flap reconstruction in recurrent basal cell carcinoma of the nose(2021)