Saved by step sections: an unusual presentation of basal cell carcinoma

Betina Werner; Fabiane Mulinari-Brenner

doi:10.5826/dpc.0101a10

Saved by step sections: an unusual presentation of basal cell carcinoma

Authors

Betina Werner Dermatopathologist, Curitiba, Parana, Brazil
Fabiane Mulinari-Brenner Dermatologist, Curitiba, Parana, Brazil

Keywords:

basal cell carcinoma, step sections, pubic region, differential diagnosis, biopsy

Abstract

Background: Basal cell carcinoma usually occurs in sun exposed areas of older male individuals.

Objectives: To emphasize the importance of histological step sections in the pursuit of the correct diagnosis when microscopic findings do not correspond to clinical hypothesis.

Patient: 21-year-old female with a superficial basal cell carcinoma in pubic region diagnosed after histological step sections and treated with topical imiquimod.

Conclusions: Although very rare, basal cell carcinomas do occur in young patients and, at times, on areas of the body where they are not conventionally seen. Step sections are an important tool that dermatopathologists should use on a regular basis to enhance diagnostic accuracy.

References

1. Roewert-Huber J, Lange-Asschenfeldt B, Stockfleth E, Kerl H. Epidemiology and aetiology of basal cell carcinoma. Br J Dermatol 2007;157(suppl 2):47-51.

2. Lear W, Dahlke E, Murray CA. Basal cell carcinoma: review of epidemiology, pathogenesis, and associated risk factors. J Cut Med Surg 2007;11(1):19-30.

3. Carucci JA, Leffell DJ. Basal cell carcinoma. In: Wolff K, Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ (eds.). Fitzpatrick’s Dermatology in General Medicine. 7th ed. New York: The McGraw-Hill Companies, Inc., 2008:1036-42.

4. Almeida AC, Yamashita T, Conte B, Mattos AC, VerÍssimo RP, Ferreira MC. [Frequency of basal cell carcinoma in a population younger than 50 years of age: clinical study and literature review]. An Bras Dermatol 2009;84(6):692-4.

5. Thomas RH, McGibbon DH, Munro DD. Basal cell carcinoma of the vulva in association with vulval lichen sclerosus et atrophicus. J Royal Soc Med 1985;78(Suppl 11):16-18.

6. Mateus C, Fortier-Beaulieu M, Lhomme C, et al. Basal cell carcinoma of the vulva: 21 cases. Ann Dermatol Venereol 2001;128(1):11-5.

7. Pisani C, Poggiali S, La De Padova L, Andreassi A, Bilenchi R. Basal cell carcinoma of the vulva. J Eur Acad Dermatol Venereol 2006;20(4):446-8.

8. Suda T, Kakinuma H. Erosive velvety lesion on the vulva-vulvar basal cell carcinoma. Arch Dermatol 2006;142(3):385-90.

9. Misago N, Suzuki Y, Miura Y, Narisawa Y. Giant polypoid basal cell carcinoma with features of fibroepithelioma of Pinkus and extensive cornification. Eur J Dermatol 2004;14(4):272-5.

10. Resnik KS, DiLeonardo M. Herpes incognito. Am J Dermatopathol.2000; 22(2):144-50.

11. Maingi CP, Helm KF. Utility of deeper sections and special stains for dermatopathology specimens. J Cutan Pathol 1998;25(3):171-5.

12. Carag HR, Prieto VG, Yballe LS, Shea RS. Utility of step sections: demonstration of additional pathological findings in biopsy samples initially diagnosed as actinic keratosis. Arch Dermatol 2000;136(4):471-5.

13. Guille DR. Accurate diagnosis of cutaneous keratinocytic neoplasms: the importance of histological step sections (and other factors). Arch Dermatol 2000;136(4):535-7.

14. Bruecks AK, Shupe LM, Trotter MJ. Prospective step sections for small skin biopsies. Arch Pathol Lab Med 2007;131(1):107-11.