Basal cell carcinoma nodular C44.L

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Synonym(s)

cystic basal cell carcinoma; Solid basal cell carcinoma; solid basalioma

Definition
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Basal cell carcinoma, which histologically consists of compact tumor cell accumulations with peripheral palisade-shaped cells without differentiation of structures of the skin appendages. Clinically mostly as nodular or nodulo-ulcerous basal cell carcinoma.

Clinical features
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  • The clinical picture of the solid basal cell carcinoma corresponds to the nodular basal cell carcinoma (see below basal cell carcinoma, nodular).
  • Initially a small, skin-coloured, waxy, shiny, rough, painless nodule with fine telangiectasia covering the edge of the nodule. Slow growth, possibly formation of several aggregated nodules. Central depression and atrophy, finally ulceration. Formation of an ulcer with a (pearl-like) edge wall consisting of shiny papules, so-called ulcer rooting.
  • Some of the solid BCCs have irregular pigmentation, whereby the pigment (melanin) may have brown or blue tones (depending on the location of the pigment accumulation, e.g. basal cell carcinoma, pigmented).

Histology
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Intense basophilic, solid epithelial strands consisting of largely uniform, cytoplasmic, basaloid cells with roundish to oval, partly also spindle, basophilic nuclei, which form palisade-like at the edges, while the inner tumor parts remain largely unstructured (see Abbott basal cell carcinoma, nodular or nodulo-ulcerous). The tumour convolutes are embedded in a compact, fibrous, connective tissue stroma. The cystic-vacuolated gaps between the tumour parenchyma and the tumour stroma, which are always present in this type of BCC, are of differential diagnostic value. In some BCC cystic degeneration foci with formation of cystic cavities occur (see also basal cell carcinoma, cystic).

Therapy
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Last updated on: 29.10.2020