Prognosis and predictive factors

BSCC is an aggressive, rapidly growing tumour characterised by an advanced stage at the time of diagnosis and a poor prognosis. Metastases to the regional lymph nodes have been reported in two thirds of patients {117,1337,1997,2128}, and distant metastases involving lungs, bone, skin and brain, in 35-50% of patients {117,1337,2128}. Although controversial, it is generally believed that BSCC is more aggressive than SCC when matched stage for stage {117,736,1337,1578,2709,2787,2798}.

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Fig. 3.16 Basaloid squamous cell carcinoma (BSCC). A Abundant intercellular hyaline globules conferring a cribriform-like pattern. B Nest of basaloid cells with peripheral palisading of the nuclei and a central keratin pearl. C Peripheral palisading of hyperchromatic columnar nuclei and areas of central necrosis. D Hyaline stromal deposits between nests of basaloid and squamous cells. E Central comedo-type of necrosis in a basaloid nest. F Peripherally palisaded nuclei with hyperchromatic nuclei in cells with high nuclear to cytoplasmic ratio. Abrupt keratinization is noted in the centre of this lobule.

Fig. 3.16 Basaloid squamous cell carcinoma (BSCC). A Abundant intercellular hyaline globules conferring a cribriform-like pattern. B Nest of basaloid cells with peripheral palisading of the nuclei and a central keratin pearl. C Peripheral palisading of hyperchromatic columnar nuclei and areas of central necrosis. D Hyaline stromal deposits between nests of basaloid and squamous cells. E Central comedo-type of necrosis in a basaloid nest. F Peripherally palisaded nuclei with hyperchromatic nuclei in cells with high nuclear to cytoplasmic ratio. Abrupt keratinization is noted in the centre of this lobule.

Fig. 3.17 Metastastatic basaloid squamous cell carcinoma in a regional lymph node, displaying both basaloid (left) and squamous (right) components.

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