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LETTER TO THE EDITOR
Year : 2014  |  Volume : 51  |  Issue : 4  |  Page : 469
 

Basaloid squamous cell carcinoma of conjunctiva: A rare entity


Department of Pathology, Pt. Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India

Date of Web Publication1-Feb-2016

Correspondence Address:
Dr. A Batra
Department of Pathology, Pt. Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0019-509X.175329

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How to cite this article:
Mathur S K, Jain P, Batra A, Sen R. Basaloid squamous cell carcinoma of conjunctiva: A rare entity. Indian J Cancer 2014;51:469

How to cite this URL:
Mathur S K, Jain P, Batra A, Sen R. Basaloid squamous cell carcinoma of conjunctiva: A rare entity. Indian J Cancer [serial online] 2014 [cited 2019 Dec 14];51:469. Available from: http://www.indianjcancer.com/text.asp?2014/51/4/469/175329


Sir,

Conjunctival squamous cell carcinoma is a rare, slow growing, low-grade malignant tumor, which may arised enovoor from pre-existing conjunctival carcinoma in situ.[1] Basaloid squamous cell carcinoma (BSCC) is an even rarer variant of squamous cell carcinoma, which occurs predominantly in men in their 60's and 70's. The most common sites to be affected are larynx, hypopharynx, tonsils and the base of tongue.[2] Only one case of BSCC of conjunctiva has been reported till date.[3] Hereby, we report second case of BSCC of conjunctiva, a rare entity.

A 60-year-male presented with a growth at limbus. On examination, it was found to be arising medially from bulbar conjunctiva near limbus. There was no evidence of either lymphatic/distant metastas is at the time of diagnosis. Excision biopsy of tumor was done by "no-touch technique" (shields) and the specimen was subjected to histopathological examination. Microscopic examination revealed tumor cells arranged in nests and islands [Figure 1] and [Figure 2]. The cells had basaloid appearance, i.e., closely apposed cells with scant cytoplasm and hyperchromatic nuclei showing peripheral palisading. Many of the nests demonstrated central keratinization inform of keratin pearls [Figure 3]. Numerous mitotic figures including a typical ones were present. Histopathological diagnosis of BSCC was rendered. However, the margins were infiltrated by the tumor. The patient is being managed further with radiotherapy.
Figure 1: Microphotograph of basaloid squamous cell carcinoma showing nests of tumor cells (H and E, ×40)

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Figure 2: Microphotograph of basaloid squamous cell carcinoma revealing surface epithelium (Hand E, ×40)

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Figure 3: Microphotograph of basaloid squamous cell carcinoma showing foci of keratin pearls (H and E, ×100)

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Squamous cell carcinoma of conjunctiva is a rare disease with a worldwide prevalence.[4] Incidence is 0.02-3.5/100,000 population.[1] Limbus is the most common site of squamous cell carcinoma. The disease is associated with exposure to ultraviolet light (sunlight) especially in Caucasian individuals.[4] BSCC was first described by Wain et al., in the upper aero digestive tract in 1986. It has strong predilection for the base of the tongue, supraglottic larynx and hypopharynx alongwith a variety of anatomic sites including the anus, thymus and uterine cervix.[3] BSCC is characterized by nesting, lobular and trabecular arrangement of small crowded cells with scant cytoplasm and hyperchromatic nuclei. The lobules of malignant basaloid cells often display peripheral nuclear palisading, high mitotic activity, comedonecros is and sometimes small cystic spaces filled with mucinous material.[3]

Clinically, it is an aggressive tumor with high rates of nodal (64%) and distant metastasis (44%). Treatment of choice is complete surgical excision supplemented by radiotherapy/adjuvant chemotherapy. The incidence of recurrence is highest in the larger lesions with involvement of margins at excision biopsy. Enucleation and exenteration is seldom required in advanced disease.[3] Rarity of this tumor in the literature promptedus to bring it to the notice of readers.

 
  References Top

1.
Chaudhry MM, Altaf S. Conjunctival squamous cell carcinoma. Prof Med J 2008;15:455-8.  Back to cited text no. 1
    
2.
Oikawa K, Tabuchi K, Nomura M, Okubo H, Wada T, Iijima T, et al. Basaloid squamous cell carcinoma of the maxillary sinus: A report of two cases. Auris Nasus Larynx 2007;34:119-23.  Back to cited text no. 2
    
3.
VasudevP, Boutross-Tadross O, Radhi J. Basaloid squamous cell carcinoma: Two case reports. Cases J 2009;2:9351.  Back to cited text no. 3
    
4.
Baig MS, Dareshani S, Ali MA, Khan MS. Squamous cell carcinoma of the conjunctiva: Analysis of fifteen cases. J Ayub Med Coll Abbottabad 2009;21:146-7.  Back to cited text no. 4
    


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