Güncel Patoloji Dergisi
2018, Cilt 2, Ek Sayı
EPS048(118 - Basaloid squamous cell carcinoma of the tonsil: Report of an aggressive rare case
Baş ve Boyun Patolojisi
1 Düzce Üniversitesi Tıp Fakültesi Tıbbi Patoloji Anabilim Dalı, Konuralp Kampüsü
Introduction
Basaloid squamous cell carcinoma (BSCC) of the palatine tonsil is an extremely uncommon and agressive tumour which is a rare morphological variant of hrHPV-associated oropharyngeal squamous cell carcinoma. It has a strong predilection for men aged between 60-80 yrs.old and sites such as base of the tongue, hypopharynx and supraglottic larynx. However the tonsil is an uncommon site of BSCC and less than 20 cases reported in the english literature.
Case Report
We aimed reporting here a rare case of BSCC located in tonsil with unique presentation. A 72 year- old female applied with swelling in the neck. She had no history of cigarette smoking or alcohol-consumption. She had hypertention and chronic obstructive lung disease controlled wiyh medication. Physical examination revealed an enlarged left tonsil with grade 2 hypertrophy. PET imaging detected a mass in left tonsil with suv-max 18,9. In the HE stained slides of tonsillectomy material, we observed nests of small basaloid pleomorphic tumor cells with hyperchromatic nuclei which shows peripheral palisading and high mitotic rate. Single cell necrosis was focally detected. Immunohistochemically, tumor cells displayed EMA, BER EP4, p63, HMWCK positivity and hrHPV negativity.
Conclusion
Basaloid squamous cell carcinoma is a rare and aggressive variant of squamous cell carcinoma with a strong predilection for the head and neck region. The upper aerodigestive tract is the most common site of origin of this tumour, especially the epiglottis, hypopharynx (piriform sinus) and base of the tongue. The histopathological hallmark of this carcinoma is its basaloid pattern, intimately associated with squamous cell carcinoma, dysplasia or focal squamous differentiation. The basaloid component consists of small, crowded cells in lobular arrangement, closely opposed to the surface mucosa. This morphological picture of the tonsil is better be kept in mind since the tumor has an aggressive behaviour. Anahtar Kelimeler : Basaloid squamous cell carcinoma, tonsil
Introduction
Basaloid squamous cell carcinoma (BSCC) of the palatine tonsil is an extremely uncommon and agressive tumour which is a rare morphological variant of hrHPV-associated oropharyngeal squamous cell carcinoma. It has a strong predilection for men aged between 60-80 yrs.old and sites such as base of the tongue, hypopharynx and supraglottic larynx. However the tonsil is an uncommon site of BSCC and less than 20 cases reported in the english literature.
Case Report
We aimed reporting here a rare case of BSCC located in tonsil with unique presentation. A 72 year- old female applied with swelling in the neck. She had no history of cigarette smoking or alcohol-consumption. She had hypertention and chronic obstructive lung disease controlled wiyh medication. Physical examination revealed an enlarged left tonsil with grade 2 hypertrophy. PET imaging detected a mass in left tonsil with suv-max 18,9. In the HE stained slides of tonsillectomy material, we observed nests of small basaloid pleomorphic tumor cells with hyperchromatic nuclei which shows peripheral palisading and high mitotic rate. Single cell necrosis was focally detected. Immunohistochemically, tumor cells displayed EMA, BER EP4, p63, HMWCK positivity and hrHPV negativity.
Conclusion
Basaloid squamous cell carcinoma is a rare and aggressive variant of squamous cell carcinoma with a strong predilection for the head and neck region. The upper aerodigestive tract is the most common site of origin of this tumour, especially the epiglottis, hypopharynx (piriform sinus) and base of the tongue. The histopathological hallmark of this carcinoma is its basaloid pattern, intimately associated with squamous cell carcinoma, dysplasia or focal squamous differentiation. The basaloid component consists of small, crowded cells in lobular arrangement, closely opposed to the surface mucosa. This morphological picture of the tonsil is better be kept in mind since the tumor has an aggressive behaviour. Anahtar Kelimeler : Basaloid squamous cell carcinoma, tonsil