Multiple lesions of granular cell basal cell carcinoma: a case report

Authors

  • Jaroslaw Jedrych,

    1. Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
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    • Present address: Department of Dermatology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
  • Klaus J. Busam

    Corresponding author
    1. Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
    • Klaus J Busam, MD

      Department of Pathology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA

      Tel: +1 212 639 5679

      Fax: +1 212 714 6224

      e-mail: busamk@mskcc.org

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Abstract

Granular cell change in basal cell carcinoma (BCC) occurs rarely. Only 11 such cases have been reported; all of them were solitary nodular BCC. We report herein a case of multiple granular cell BCC with infundibulocystic features. The tumors presented as papules on the anterior neck of a 44-year-old female with a prior history of a well-differentiated squamous cell carcinoma (SCC) of the tongue and radiation involving the area in which BCC developed. Microscopically, the tumors were circumscribed small dermal nodules composed of epithelial cords with granular eosinophilic cytoplasm and entrapped infundibular keratocysts. Given the eosinophilic appearance of the tumor, history of SCC and the lesions multiplicity, the initial biopsy was first interpreted as metastatic SCC. The correct diagnosis of granular cell BCC was established upon rereview of the slides at a cancer center. Given the diagnostic controversy, immunohistochemical stains were performed. The tumor cells expressed Ber-EP4, CD63 (NKI/C3) and CD68. The tumors were compared to the prior SCC finding different morphologies. Extensive clinical evaluation showed no evidence of recurrent SCC. This report expands the clinicopathologic spectrum of granular cell variant of BCC and documents for the first time eruption of multiple such tumors in a localized area.

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