Esophagus
Carcinoma
Basaloid squamous cell carcinoma

Author: Elliot Weisenberg, M.D. (see Authors page)

Revised: 22 January 2018, last major update September 2013

Copyright: (c) 2003-2018, PathologyOutlines.com, Inc.

PubMed Search: Basaloid squamous cell carcinoma esophagus

Cite this page: Weisenberg, E. Basaloid squamous cell carcinoma. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/esophagusbasaloidSCC.html. Accessed October 16th, 2018.
Definition / general
  • Variant of squamous cell carcinoma with distinct basaloid morphology
Epidemiology
  • Generally older males
  • Reported incidence from 1 - 11% of squamous cell carcinomas; true incidence likely ~2%
Sites
  • More common in mid to distal esophagus
Pathophysiology
Clinical features
  • Patients present with dysphagia and weight loss
  • Usually widespread metastases at presentation
Diagnosis
  • Endoscopic biopsy
Prognostic factors
  • Very poor prognosis in most cases (World J Gastroenterol 1998;4:397, Cancer 1997;79:1871)
  • Better prognosis that occurs with HPV associated basaloid squamous cell carcinoma of upper aerodigestive tract is different from basaloid squamous cell carcinoma of esophagus
Case reports
Treatment
  • Same as conventional squamous cell carcinoma
  • Often unresectable due to advanced stage
Gross description
  • Generally deeply invasive, large bulky ulcerated fungating masses
Microscopic (histologic) description
  • Solid, cribriform or microcystic nests, strands, trabeculae or lobules of tumor cells (Histopathology 2000;36:331)
  • Strands of tumor cells often connected to overlying squamous epithelium
  • Nuclei are round to oval with hyperchromatic nuclei with peripheral palisading, often with central comedo type necrosis
  • Many mitotic figures
  • Microcystic pattern contains basophilic material
  • While microcysts or necrosis may cause a resemblance to lumina, true lumens are lacking
  • Many have areas of stromal hyalinization
  • Often admixed with conventional invasive or in situ squamous cell carcinoma and may see admixed adenocarcinoma, small cell carcinoma and spindle cell squamous cell carcinoma
Microscopic (histologic) images

Images hosted on PathOut server:

Small dark tumor cells

Peripheral basal type cells

Focus of squamous differentiation

Strands of tumor cells touch epithelium



Images hosted on other servers:

Composed of solid nests and strands of basaloid cells

Comedo type
necrosis and focal
areas of squamous
differentiation

AE1 / AE3 and patchy S100

H&E and BCL2

Negative stains
Electron microscopy description
  • Relatively undifferentiated cellular characteristics
  • Undeveloped cell organelles
  • Markedly replicated basement membrane
Molecular / cytogenetics description
Differential diagnosis