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Case Reports
. 2022 Mar 23;29(4):2193-2198.
doi: 10.3390/curroncol29040178.

Basosquamous Basal Cell Carcinoma with Bone Marrow Metastasis

Lise Mayrin Økland Thunestvedt  1 , Lars Helgeland  2   3 , Ingeborg Margrethe Bachmann  2   4 , Åsa Karlsdottir  5 , Torjan Magne Haslerud  6 , Håkon Reikvam  1   7
Affiliations
Case Reports

Basosquamous Basal Cell Carcinoma with Bone Marrow Metastasis

Lise Mayrin Økland Thunestvedt et al. Curr Oncol. .

Abstract

Basal cell carcinoma (BCC) is the most common cancer in Caucasians. It is slow growing and rarely metastasizes. If left untreated over time, invasive growth can occur. We present a patient case with a primary BCC located in the right sub-mammary area, with extensive metastases to the skeleton and bone marrow. Histopathological examination of the tumour showed BCC with a diverse growth pattern. There were no signs of local metastases. Surgery was successfully performed. Three months post-surgery the patient developed normocytic anaemia and elevated inflammation markers. [18F]FDG PET/CT showed extensive FDG uptake in the entire skeleton and bone marrow. Biopsy confirmed the infiltration of BCC with similar histopathological features as the primary tumour. Prognosis of metastasized BCC is poor and, therefore, long-term follow-up of patients with risk factors is of importance.

Keywords: basal cell carcinoma; bone marrow invasion; bone marrow metastasis; nonmelanoma skin cancer.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Ulcerative tumour. The picture shows a large infiltrating and ulcerative tumour inferior of the right breast.
Figure 2
Figure 2
Histopathological features of metastatic BCC. The images show histopathological features from the original skin tumour (A,B), and from bone marrow biopsy with metastases (C–F). (A) Tumour showing irregular growth of basaloid tumour islets with palisading of nuclei and cleft formation peripherally in the tumour islets. (B) Strikingly infiltrative growth pattern (morphoea-like) with invasion and destruction of rib bone tissue. (C) Bone marrow biopsy low-power view showing extensive infiltration of marrow spaces. (D) Bone marrow infiltrated by malignant tumour tissue growing in irregular islands. (E) Irregular tumour islands with destruction of bony trabeculae. (F) Tumour cells are medium sized with light eosinophilic cytoplasm with round to oval nuclei with somewhat uneven nucleus contour and palisading, compatible with metastatic BCC.
Figure 3
Figure 3
[18F]FDG-PET/CT of the vertebral column/bone marrow. The pictures demonstrate extensive FDG-uptake in the whole axial skeleton.
See this image and copyright information in PMC

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