Pathology Unit, Department of Medical and Surgical Sciences, University of Cantabria, Santander, Spain;
Rom J Morphol Embryol. 2022 Jan-Mar;63(1):221-228. doi: 10.47162/RJME.63.1.25.
Basaloid squamous cell carcinoma (BSCC) is an aggressive type of squamous cell carcinoma (SCC) predominant in the upper aerodigestive tract. To our knowledge, only one case of that tumor has been previously described in the parotid gland. Shadow (ghost) cell differentiation (SCD) is a specialized form of keratinization characteristic of pilomatricoma, and other skin tumors with follicular differentiation. SCD has also been described infrequently in some visceral carcinomas and rarely in the minor salivary glands. Recently, an SCC with prominent SCD has been reported in the parotid. We report for the first time the case of parotid BSCC with prominent SCD in an 87-year-old man. He was admitted due to the appearance in the last few months of a mass, painful on palpation, in the left parotid region. Imaging studies and tru-cut biopsies indicated the need for surgical removal. A left superficial parotidectomy, including the branch of the cervicofacial nerve, was performed. The BSCC showed predominance (62%) of SCD. Immunohistochemically, the basaloid cells were positive for β-catenin, pan-cytokeratin (pan-CK) AE1∕AE3, CK19, high-molecular-weight CK (HMWCK), p63, p40, and cluster of differentiation 10 (CD10) in a diffuse pattern. No signs of recurrence or metastasis were observed four months after surgery. The main differential diagnoses include nuclear protein in testis (NUT) carcinoma, adamantinoma-like Ewing sarcoma, embryonal carcinoma, and basal cell adenocarcinoma of the solid type. SCD in BSCC of the parotid should be recognized to avoid misdiagnosis, especially in small samples. Although rare, BSCC with SCD should be added to the list of tumors that may originate in the parotid gland.
基底样鳞状细胞癌 (BSCC) 是一种侵袭性的鳞状细胞癌 (SCC)，主要发生在上呼吸道。据我们所知，这种肿瘤以前只在腮腺中描述过一例。影子 (幽灵) 细胞分化 (SCD) 是毛母细胞瘤和其他具有滤泡分化的皮肤肿瘤的一种特殊角化形式。SCD 也在一些内脏癌中罕见地描述过，在小涎腺中也很少见。最近，有报道称腮腺中有 SCC 伴显著 SCD。我们首次报道了一例 87 岁男性腮腺 BSCC 伴显著 SCD。他因在过去几个月内出现左腮腺区触痛性肿块而入院。影像学研究和 tru-cut 活检表明需要手术切除。行左侧腮腺浅叶切除术，包括颈面神经分支。BSCC 显示 SCD 占主导地位 (62%)。免疫组织化学染色显示，基底样细胞β-连环蛋白、广谱细胞角蛋白 (pan-CK) AE1∕AE3、CK19、高分子量 CK (HMWCK)、p63、p40 和分化簇 10 (CD10) 弥漫阳性。术后 4 个月无复发或转移迹象。主要鉴别诊断包括睾丸核蛋白 (NUT) 癌、似造釉细胞瘤样尤文肉瘤、胚胎癌和实性型基底细胞腺癌。腮腺 BSCC 中 SCD 的存在应予以识别，以避免误诊，特别是在小样本中。虽然罕见，但应将伴有 SCD 的 BSCC 添加到可能来源于腮腺的肿瘤列表中。
