TITLE:
Basosquamous Cell Carcinoma of the Lower Lip Arising from Actinic Cheilitis: Case Report and up Date
AUTHORS:
Ana Maria de Oliveria Miranda, Thiago de Miranda Ferrari, Daniel Cohen Goldemberg, Luciana Pantaleão, Andrea Pires, Eliane Pedra Dias
KEYWORDS:
Basosquamous Carcinoma; Lip; Actinic Cheilitis; Basal Cell Carcinoma
JOURNAL NAME:
International Journal of Clinical Medicine,
Vol.4 No.12A,
December
30,
2013
ABSTRACT:
Background: Basosquamous carcinoma (BSC) is a rare
non-melanoma skin cancer, considered to be a subtype of basal cell carcinoma
(BCC). BSC often produces distant metastases with a higher risk of recurrence
than that of BCC which is not commonly found in the lip. Case Report: A 57-year-old white female
patient presented an ulcer on her lower lip that had an ongoing development for
over six months. Physical examination, photo documentation, videoroscopy,
scraped cytology, toluidine blue test, and biopsy of the ulcer were carried
out. Results: Upon
physical examination we observed an actinic cheilitis associated with the
ulcer. Videoroscopy revealed the presence of fissures and erosion that had not been seen by oroscopy.
Toluidine blue test was only positive for the region of the ulcer. Cytological
analysis revealed rare nests compatible with carcinoma. Histopathology of the
biopsy revealed a carcinoma with nests lined by basal cells associated with
areas of squamous differentiation. The patient was then referred to surgery for the
removal of the BCC. Analysis of the specimen showed free surgical margins and
the immunohistochemical panel did not confirm the initial diagnosis of BCC,
indicating a subtype of BSC. After surgery, the patient has been followed by
periodic consultations. She is well and without further complications. Coments: BSC is
considered to be an aggressive and rare tumor affecting mainly upper face and
primarily affects men over 60 years of age. Since our patient is a woman presenting the lesion in the lower lip, this highlights the unusual and interesting presentation of
this case report.