Skip to main content

Advertisement

SpringerLink
Log in

Intraoral Basal Cell Carcinoma, a Rare Neoplasm: Report of Three New Cases with Literature Review

  • Case Report
  • Published:
Head and Neck Pathology Aims and scope Submit manuscript

Abstract

Intraoral basal cell carcinoma (IOBCC) is an extremely rare entity that bears close microscopic resemblance to and is often confused with the peripheral ameloblastoma (PA). Basal cell carcinomas are thought to arise from pluripotential basal cells present within surface epithelium and adnexal structures, so theoretically they can arise within the oral cavity. Many of the early cases reported as IOBCC actually represent PA. Most of the well documented cases arise from the gingiva. The histologic features of basal cell carcinoma that help separate it from a PA include: tumor arising from surface epithelium, scattered mitotic figures and apoptotic cells, presence of mucoid ground substance and tumor infiltrating widely throughout the connective tissue and often exhibiting a prominent retraction artifact. Clinically IOBCC resemble carcinomas, compared to the benign and innocuous appearance of the PA and typically presents as surface ulcerations varying from rodent ulcer to an ulcerated erythroplakia appearance. This contrasts with the classic “bump on the gum” appearance of PAs with usually intact surface and appearing as small discrete, sessile, exophytic lesions. Importantly, the proliferative basaloid epithelium demonstrates positive immunoreactivity for the anti-epithelial antibody, Ber-EP4, a cell surface glycoprotein. The IOBCC has the potential for local recurrence and aggressive behavior and should be treated with wide surgical excision and close clinical follow up. We present 3 rare cases of IOBCC and discuss the salient histologic, immunohistochemical and clinical features.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

References

  1. Wu S, Han J, Li WQ, Li T, Qureshi AA Basal-cell carcinoma incidence and associated risk factors in US women and men. Am J Epidemiol. 2013;178(6):890–7.

    Google Scholar 

  2. Luzar B, Bastian BC, Calonje E: Mckee’s Pathology of the Skin. Mckee PH editors. Amsterdam: Elsevier; 2012.

  3. Bath-Hextall F, Leonardi-Bee J, Smith C, Meal A, Hubbard R. Trends in incidence of skin basal cell carcinoma. Additional evidence from a UK primary care database study. Int J Cancer. 2007;121:2105–8.

    Article  CAS  PubMed  Google Scholar 

  4. Saint CF. The embryology of the stomodeum and its bearing on the pathology of tumours of the tongue and the salivary glands. S Afr J Clin Sci. 1951;2:1–17.

    CAS  PubMed  Google Scholar 

  5. Del Rosario RN, Barr RJ, Jensen JL, Cantos KA. Basal cell carcinoma of the buccal mucosa. Am J Dermatopathol. 2001;23:203–5.

    Article  PubMed  Google Scholar 

  6. Shumway BS, Kalmar JR, Allen CM, Rawal YB. Basal cell carcinoma of the buccal mucosa in a patient with nevoid basal cell carcinoma syndrome. Int J Surg Pathol. 2011;19:348–54.

    Article  PubMed  Google Scholar 

  7. Latza U, Niedobitek G, Schwarting R, Nekarda H, Stein H. Ber-EP4: new monoclonal antibody which distinguishes epithelia from mesothelial. J Clin Pathol. 1990;43:213–9.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  8. Tellechea O, Reis JP, Domingues JC, Baptista AP. Monoclonal antibody Ber EP4 distinguishes basal-cell carcinoma from squamous-cell carcinoma of the skin. Am J Dermatopathol. 1993;15:452–5.

    Article  CAS  PubMed  Google Scholar 

  9. Yu L, Galan A, McNiff JM. Caveats in BerEP4 staining to differentiate basal and squamous cell carcinoma. J Cutan Pathol. 2009;36:1074–176.

    Article  PubMed  Google Scholar 

  10. Winters R, Naud S, Evans MF, Trotman W, Kasznica P, Elhosseiny A. Ber-EP4, CK1, CK7 and CK14 are useful markers for basaloid squamous carcinoma: a study of 45 cases. Head Neck Pathol. 2008;2:265–71.

    Article  PubMed Central  PubMed  Google Scholar 

  11. el-Mofty SK, Gerard NO, Farish SE, Rodu B. Peripheral ameloblastoma: a clinical and histologic study of 11 cases. J Oral Maxillofac Surg. 1991;49:970–4 discussion 974-975.

    Article  CAS  PubMed  Google Scholar 

  12. Ide F, Mishima K, Miyazaki Y, Saito I, Kusama K. Peripheral ameloblastoma in situ: an evidential fact of surface epithelium origin. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009;108:763–7.

    Article  PubMed  Google Scholar 

  13. Beer TW, Shepherd P, Theaker JM. Ber EP4 and epithelial membrane antigen aid distinction of basal cell, squamous cell and basosquamous carcinomas of the skin. Histopathology. 2000;37:218–23.

    Article  CAS  PubMed  Google Scholar 

  14. Fan YS, Carr RA, Sanders DS, Smith AP, Lazar AJ, Calonje E. Characteristic Ber-EP4 and EMA expression in sebaceoma is immunohistochemically distinct from basal cell carcinoma. Histopathology. 2007;51:80–6.

    Article  CAS  PubMed  Google Scholar 

  15. Weedon D Tumours of the epidermis. In: Weedon D editors. Edinburgh, Churchill Livingstone Elsevier, 2010; p. 685–686.

  16. Barnhill RL Tumors of the epidermis. In: Crowson AN, editors. New York, McGraw HIll, 2004; p. 599–608.

  17. Kuru H. Uber das Adamantinoma. Zentralbl allg path u Path Anatomie (Iena). 1911;22:291–5.

    Google Scholar 

  18. Stanley HR Jr, Krogh HW. Peripheral ameloblastoma; report of a case. Oral Surg Oral Med Oral Pathol. 1959;12:760–5.

    Article  PubMed  Google Scholar 

  19. LeCorn DW, Bhattacharyya I, Vertucci FJ. Peripheral ameloblastoma: a case report and review of the literature. J Endod. 2006;32:152–4.

    Article  PubMed  Google Scholar 

  20. Kato H, Ota Y, Sasaki M, Karakida K, Kaneko A, Sekido Y, Tsukinoki K. Peripheral ameloblastoma of the lower molar gingiva: a case report and immunohistochemical study. Tokai J Exp Clin Med. 2012;37:30–4.

    PubMed  Google Scholar 

  21. Vigneswaran N, Whitaker SB, Budnick SD, Waldron CA. Expression patterns of epithelial differentiation antigens and lectin-binding sites in ameloblastomas: a comparison with basal cell carcinomas. Hum Pathol. 1993;24:49–57.

    Article  CAS  PubMed  Google Scholar 

  22. Koutlas IG, Koch CA, Vickers RA, Brouwers FM, Vortmeyer AO. An unusual ostensible example of intraoral basal cell carcinoma. J Cutan Pathol. 2009;36:464–70.

    Article  PubMed  Google Scholar 

  23. Yamamoto T, Ueta E, Yoneda K, Osaki T. Peripheral ameloblastoma: case report with immunohistochemical investigation. J Oral Maxillofac Surg. 1990;48:197–200.

    Article  CAS  PubMed  Google Scholar 

  24. Lawson BF, Griffin JW, Waldron CA. Basal-cell carcinoma of the gingiva. Report of a case. Oral Surg Oral Med Oral Pathol. 1967;24:648–53.

    Article  CAS  PubMed  Google Scholar 

  25. Mori M, Morimoto Y, Yoshimura Y, Kawamura H. Enzymatic histochemical demonstration of basal-cell carcinoma in the oral cavity. Oral Surg Oral Med Oral Pathol. 1968;25:746–55.

    Article  CAS  PubMed  Google Scholar 

  26. Peters RA, Gingrass RP, Reyes CN, Hintz CS. Basal cell carcinoma of the oral cavity: report of case. J Oral Surg. 1972;30:63–6.

    CAS  PubMed  Google Scholar 

  27. Liroff KP, Zeff S. Basal cell carcinoma of the palatal mucosa. J Oral Surg. 1972;30:730–3.

    CAS  PubMed  Google Scholar 

  28. Samit AM. Intraoral basal cell carcinoma. J Surg Oncol. 1978;10:27–32.

    Article  CAS  PubMed  Google Scholar 

  29. Simpson HE. Basal-cell carcinoma and peripheral ameloblastoma. Oral Surg Oral Med Oral Pathol. 1974;38:233–40.

    Article  CAS  PubMed  Google Scholar 

  30. Thoma KH, Goldman HM Oral pathology. Edited by St. Louis, MO, CV Mosby, 1960.

  31. Williamson JJ, Cohney BC, Henderson BM. Basal cell carcinoma of the mandibular gingiva. Arch Dermatol. 1967;95:76–80.

    Article  CAS  PubMed  Google Scholar 

  32. Keen RR, Elzay RP. Basal cell carcinoma from mucosal surface of lower lip: report of case. J Oral Surg Anesth Hosp Dent Serv. 1964;22:453–5.

    CAS  PubMed  Google Scholar 

  33. Blinder D, Taicher S. Metastatic basal cell carcinoma presenting in the oral cavity and auditory meatus. A case report and review of literature. Int J Oral Maxillofac Surg. 1992;21:31–4.

    CAS  PubMed  Google Scholar 

  34. Edmondson HD, Browne RM, Potts AJ. Intra-oral basal cell carcinoma. Br J Oral Surg. 1982;20:239–47.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

We would like to thank Dr. Samuel L. Bobek, M.D. D.M.D of Portland, OR for his case contribution.

Author information

Authors and Affiliations

  1. Department of Oral and Maxillofacial Pathology, University of Florida College of Dentistry, Gainesville, FL, USA

    T. R. Woods, D. M. Cohen, M. N. Islam & I. Bhattacharyya

  2. Department of Pathology and Radiology, Oregon Health and Science University School of Dentistry, Portland, OR, USA

    F. J. Kratochvil & J. C. B. Stewart

  3. Private Practice Limited to Oral and Maxillofacial Surgery, Jacksonville, FL, USA

    S. L. Reeder

  4. Division of Oral Pathology, Department of Oral and Maxillofacial Diagnostic Sciences, University of Florida College of Dentistry, PO Box 100414 JHMHC, Gainesville, FL, 32610-0414, USA

    I. Bhattacharyya

Authors
  1. T. R. Woods
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. D. M. Cohen
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. M. N. Islam
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. F. J. Kratochvil
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. J. C. B. Stewart
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. S. L. Reeder
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. I. Bhattacharyya
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to I. Bhattacharyya.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Woods, T.R., Cohen, D.M., Islam, M.N. et al. Intraoral Basal Cell Carcinoma, a Rare Neoplasm: Report of Three New Cases with Literature Review. Head and Neck Pathol 8, 339–348 (2014). https://doi.org/10.1007/s12105-013-0505-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12105-013-0505-5

Keywords

Search

Navigation