BACKGROUND/OBJECTIVES: To determine the incidence, proportion and location of periocular tumours in an English county over a five year period, and compare to other studies in the UK and worldwide. SUBJECTS/METHODS: A retrospective review of histopathology reports was performed for all periocular excision biopsies of malignancies from the county's three main hospitals over a 5-year period. These hospitals cover a population of just over one million. Tumours were classified according to type and location. RESULTS: 1220 lesions were included in this study. Right-sided lesions were more common than left. The incidence of basal cell carcinoma was 22 per 100,000 and squamous cell carcinoma 1.3 per 100,000, which were found most commonly on the lower eyelid and eyebrow respectively. The incidences of all other types of lesions were less than 0.5 per 100,000 per year. CONCLUSIONS: The incidence of periocular basal cell carcinomas in the predominantly elderly Caucasian population was at least three times the published national average. The high incidence of periocular tumours in this North East Anglian county is set to increase further as the proportion of over 65 year olds in the population is predicted to nearly double within two decades.
- MeSH
- bazocelulární karcinom * patologie MeSH
- lidé MeSH
- nádory kůže * patologie MeSH
- nádory očního víčka * patologie MeSH
- oční víčka chirurgie MeSH
- retrospektivní studie MeSH
- senioři MeSH
- spinocelulární karcinom * patologie MeSH
- Check Tag
- lidé MeSH
- senioři MeSH
- Publikační typ
- časopisecké články MeSH
- komentáře MeSH
- multicentrická studie MeSH
BACKGROUND: Histopathological classification of basal cell carcinoma (BCC) has important prognostic and therapeutic implications, but reproducibility of BCC subtyping among dermatopathologists is poor. OBJECTIVES: To obtain a consensus paper on BCC classification and subtype definitions. METHODS: A panel of 12 recognized dermatopathologists (G12) from nine European countries used a modified Delphi method and evaluated 100 BCC cases uploaded to a website. The strategy involved five steps: (I) agreement on definitions for WHO 2018 BCC subtypes; (II) classification of 100 BCCs using the agreed definitions; (III) discussion on the weak points of the WHO classification and proposal of a new classification with clinical insights; (IV) re-evaluation of the 100 BCCs using the new classification; and (V) external independent evaluation by 10 experienced dermatopathologists (G10). RESULTS: A simplified classification unifying infiltrating, sclerosing, and micronodular BCCs into a single "infiltrative BCC" subtype improved reproducibility and was practical from a clinical standpoint. Fleiss' κ values increased for all subtypes, and the level of agreement improved from fair to moderate for the nodular and the unified infiltrative BCC groups, respectively. The agreement for basosquamous cell carcinoma remained fair, but κ values increased from 0.276 to 0.342. The results were similar for the G10 group. Delphi consensus was not achieved for the concept of trichoblastic carcinoma. In histopathological reports of BCC displaying multiple subtypes, only the most aggressive subtype should be mentioned, except superficial BCC involving margins. CONCLUSIONS: The three BCC subtypes with infiltrative growth pattern, characteristically associated with higher risk of deep involvement (infiltrating, sclerosing, and micronodular), should be unified in a single group. The concise and encompassing term "infiltrative BCCs" can be used for these tumors. A binary classification of BCC into low-risk and high-risk subtypes on histopathological grounds alone is questionable; correlation with clinical factors is necessary to determine BCC risk and therapeutic approach.
- MeSH
- bazocelulární karcinom * patologie MeSH
- konsensus MeSH
- lidé MeSH
- nádory kůže * patologie MeSH
- reprodukovatelnost výsledků MeSH
- resekční okraje MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
PURPOSE OF REVIEW: Due to the limited number of cases, there are no guidelines for basal cell carcinoma (BCC) of the prostate. This review combines an unpublished case report of a 55-year-old patient with BCC with an assessment of the latest literature. RECENT FINDINGS: BCC of the prostate has previously been described in only approximately 140 cases. We describe the diagnostic process, including the uropathological and DNA-sequencing results, which allowed us to start an experimental treatment with pemigatinib. BCC of the prostate is associated with an aggressive biological and clinical behavior, such as recurrence and metastasis. Several immunohistochemical stainings are available to differentiate BCC from adenocarcinoma of the prostate. Based on pathology and results from next-generation sequencing (NGS), patients can be offered targeted therapies. SUMMARY: With the aid of histological work-up and immunostaining, prostatic BCC can be accurately diagnosed. Our patient underwent radical prostatectomy and staged extended lymphadenectomy due to lymph node recurrence. The patient subsequently developed progressive disease and was treated with the FGFR-inhibitor pemigatinib. The patient's liver metastasis significantly responded. The present case confirms the possibility of aggressive behavior of prostatic BCC and highlights the importance of a thorough uropathological and molecular biological analysis with a precision medicine strategy.
- MeSH
- bazocelulární karcinom * diagnóza patologie chirurgie MeSH
- lidé středního věku MeSH
- lidé MeSH
- lymfadenektomie MeSH
- morfoliny MeSH
- nádory kůže * chirurgie MeSH
- nádory prostaty * diagnóza farmakoterapie genetika MeSH
- prostata patologie MeSH
- prostatektomie MeSH
- pyrimidiny MeSH
- pyrroly MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
- přehledy MeSH
- Klíčová slova
- cemiplimab,
- MeSH
- bazocelulární karcinom * diagnóza patologie terapie MeSH
- humanizované monoklonální protilátky aplikace a dávkování terapeutické užití MeSH
- lidé MeSH
- metastázy nádorů farmakoterapie MeSH
- nádory hlavy a krku farmakoterapie sekundární MeSH
- nádory ucha diagnóza terapie MeSH
- protokoly antitumorózní kombinované chemoterapie MeSH
- senioři MeSH
- spinocelulární karcinom * diagnóza patologie terapie MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
- Klíčová slova
- vismodegib,
- MeSH
- bazocelulární karcinom * chirurgie diagnóza farmakoterapie patologie terapie MeSH
- dermatologické látky aplikace a dávkování ekonomika škodlivé účinky MeSH
- lidé MeSH
- pyridiny aplikace a dávkování ekonomika škodlivé účinky MeSH
- senioři nad 80 let MeSH
- signální transdukce účinky léků MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- Publikační typ
- kazuistiky MeSH
- MeSH
- bazocelulární karcinom * chemicky indukované chirurgie diagnostické zobrazování patologie MeSH
- dermatoskopie MeSH
- histologické techniky MeSH
- hýždě patologie MeSH
- lidé MeSH
- orchiektomie MeSH
- radioterapie škodlivé účinky MeSH
- seminom chirurgie radioterapie MeSH
- senioři MeSH
- testikulární nádory * chirurgie radioterapie MeSH
- výsledek terapie MeSH
- záda patologie MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- Publikační typ
- kazuistiky MeSH
- MeSH
- bazocelulární karcinom * chirurgie diagnostické zobrazování patologie MeSH
- čelo anatomie a histologie patologie MeSH
- komorbidita MeSH
- lentigo maligna kůže * chirurgie diagnostické zobrazování patologie MeSH
- lidé MeSH
- nádory kůže chirurgie diagnostické zobrazování patologie MeSH
- senioři nad 80 let MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- Publikační typ
- kazuistiky MeSH
Prostatic basal cell carcinoma is a malignant neoplasm composed of basaloid cells forming infiltrative nests and tubules, which may potentially be misdiagnosed as benign basal cell proliferations (i.e., florid basal cell hyperplasia or basal cell adenoma) and also closely resembles adenoid cystic carcinoma of the salivary gland. MYB-NFIB gene rearrangement occurs in 30-86% of salivary gland adenoid cystic carcinomas. We sought to further characterize MYB gene rearrangement in prostatic basal cell carcinoma and correlate MYB-NFIB fusion status with other clinicopathologic characteristics. To this end, FISH analysis for MYB-NFIB gene fusion using fusion probes was performed on formalin-fixed, paraffin-embedded tissue sections from prostatic basal cell carcinoma (n = 30), florid basal cell hyperplasia (n = 18), and basal cell adenoma (n = 4). Fourteen of 30 (47%) cases of basal cell carcinoma were positive for MYB-NFIB gene fusion FISH, and no cases of benign basal cell proliferations were positive (p < 0.05). FISH-positive patients (mean age = 63 years, range: 35-81) tended to be younger than FISH-negative patients (mean age = 70 years, range: 55-93). Most FISH-positive cases demonstrated adenoid cystic carcinoma-like morphology (57%), and most FISH-negative cases demonstrated nonadenoid cystic carcinoma-like morphology (93%); one case (FISH-positive) demonstrated areas with both adenoid cystic carcinoma-like and nonadenoid cystic carcinoma-like morphology. FISH-positive cases more frequently demonstrated perineural invasion (50% vs. 14%, p < 0.05) compared to FISH-negative cases. Conversely, tall basal cells (i.e., neoplastic cells at least two times taller than wide) were more frequent in FISH-negative cases than FISH-positive cases (93% vs. 36%, p < 0.05). Approximately, 50% of prostatic basal cell carcinoma harbor MYB-NFIB gene fusion. The majority of these cases were characterized by adenoid cystic carcinoma-like morphology, perineural invasion, and lack tall basal cells. Florid basal cell hyperplasia and basal cell adenoma are negative for MYB-NFIB gene fusion.
- MeSH
- adenom genetika patologie MeSH
- bazocelulární karcinom genetika patologie MeSH
- dospělí MeSH
- fúzní onkogenní proteiny genetika MeSH
- hyperplazie genetika patologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- nádory prostaty genetika patologie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- Publikační typ
- časopisecké články MeSH
- srovnávací studie MeSH
Bazocelulární karcinom (BCC, basal cell carcinoma) je nejčastější karcinom s nízkým maligním potenciálem a mortalitou a při včasné diagnostice s vysokou kurabilitou. Vyskytuje se v různých klinických formách, histologických variantách s odlišnou rizikovostí. Včasná diagnostika, založená na zkušenostech, dobré znalosti klinického obrazu a histologických variant, je předpokladem výběru optimální modality léčby jak primárního nádoru, tak i případné recidivy. V léčbě je dominantní chirurgie, jen při její kontraindikaci lze použít nechirurgické metody, radiační léčbu, kryodestrukci, laser, fotodynamickou léčbu nebo léčbu topickou. Pro pokročilý nebo metastazující BCC se v léčbě využívá první inhibitor signální dráhy hedgehog - vismodegib.
Basal cell carcinoma is the most common carcinoma with low malignant potential and mortality, and in early diagnosis with high curability. It occurs in different clinical forms, histological variants with different risk. Early diagnostics, based on experience, good clinical knowledge and histological variants, is a prerequisite for choosing the optimal modal treatment of both primary and recurrent treatment. Dominant surgery is the only surgical procedure in which contraindication can be done with non-surgical methods, radiation therapy, cryodestruction, photodynamic therapy or topical treatment. For advanced or metastatic basal cell carcinoma, vismodegib the first inhibitor hedgehog signaling pathway is used.
- Klíčová slova
- Vismodegib,
- MeSH
- bazocelulární karcinom * klasifikace patologie terapie MeSH
- časná detekce nádoru MeSH
- dermatochirurgické výkony metody normy MeSH
- fotochemoterapie metody MeSH
- kryochirurgie metody MeSH
- lidé MeSH
- prognóza MeSH
- proteiny hedgehog metabolismus škodlivé účinky účinky léků MeSH
- radioterapie metody MeSH
- recidiva MeSH
- Check Tag
- lidé MeSH
Východiská: Nemelanómové zhubné nádory kože (non-melanoma skin cancer – NMSC) sú najčastejšou malignitou u ľudí svetlej pleti. V praxi zahrňujú najmä dva keratinocytové nádory – bazocelulárny karcinóm (basal cell carcinoma – BCC) a skvamocelulárny karcinóm (squamous cell carcinoma – SCC). Cieľom prezentovanej štúdie bolo analyzovať a porovnávať klinicko-patologické rozdiely ochorenia u pacientov s BCC a SCC kože. Materiál a metodika: Hodnotený súbor pozostával z 541 osôb so 719 BCC a 126 osôb so 162 SCC. Výsledky: V skupine pacientov s BCC bolo zastúpenie mužov (49,91 %) a žien (50,09 %) prakticky vyrovnané, avšak SCC sa vyskytovali omnoho častejšie u mužov (68,2 %) než u žien (31,8 %). Priemerný vek pacientov s BCC bol 70,8 rokov a so SCC 78,2 rokov. Prevalencia BCC začala výraznejšie stúpať od 50. roku života, od ktorého mal vzostup lineárny trend až do 80. roku s následným poklesom. SCC sa začal výraznejšie vyskytovať od 70. roku života, od ktorého prevalencia strmo stúpala a nadobúdala exponenciálny trend. BCC aj SCC boli lokalizované najmä na hlave a krku, ktoré predstavovali 69,8 a 81,4 % všetkých prípadov. BCC však boli diagnostikované častejšie na tvári a naopak, SCC frekventovanejšie v extrafaciálnych partiách hlavy. Okrem toho sa BCC v porovnaní so SCC vyskytovali podstatne častejšie na trupe, najmä na chrbte. Záver: Hoci sú BCC a SCC zahrnuté pod jednotný termín NMSC, vo viacerých klinicko-patologických znakoch sa odlišujú. Napriek podobným etiologickým faktorom by ich bolo prinajmenej z onkoepidemiologického hľadiska vhodné hodnotiť individuálne.
Background: Non-melanoma skin cancer (NMSC) is the most common malignancy in Caucasians. It mainly includes two major keratinocyte tumors – basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). The objective of the study was to analyze and compare the clinicopathological differences between patients with BCC and SCC of the skin. Material and Methods: A cohort of 541 patients with a total of 719 BCCs, and 126 patients with a total of 162 SCCs were retrospectively analyzed. Results: While there was virtually the same proportion of men (49.91%) and women (50.09%) in BCC patients, SCCs occurred more frequently in men (68.2%) than in women (31.8%). The mean age of the individuals with BCC and SCC was 70.8 and 78.2 years, resp. The number of BCCs rises from 50 years of age and this increase showed a linear trend up to 80 years, subsequently followed by decline. SCC lesions occur more rapidly from 70 years of age followed by a sharp increase that exhibited an exponential relationship. BCCs and SCCs occurred predominantly on the head and neck region, comprising a total of 69.8% and 81.4% of the cases, resp. However, BCC lesions were seen more often on the face and SCC lesions were diagnosed more frequently on the extra-facial parts of the head. Further, BCCs occurred more frequently on the trunk, and particularly on the back, compared to SCCs. Conclusion: Although BCC and SCC are covered under common term NMSC, they manifest several clinicopathological differences. Despite sharing common etiologic determinants, at least from the onco-epidemiologic perspective, they should be considered separately.
