Basosquamous Carcinoma: Report of Two Cases and Review of Literature

Background: Basosquamous cell carcinoma (BSCC) or metatypical carcinoma is a poorly known cutaneous tumor that is considered as an aggressive type of basal cell carcinoma with an increased risk of recurrences and metastases. The most common onset is in the head and neck region. Methods: We present two cases of basosquamous carcinoma of lower extremity, in which a longstanding lesion initially diagnosed as basal cell carcinoma for one case, and as squamous cell carcinoma for the second case, and were later found to have basosquamous histology. Both patients received surgical treatment with good evolution. Conclusion: Metatypical basal cell carcinoma or basosquamous Cell carcinoma (BSCC), is a rare skin carcinoma, potentially aggressive entity with clinical and pathological characteristics of CBC and CSC, considered as a variant of CBC, but is currently defined as a tumor complex. Although clinically similar to BCC, it is more aggressive and metastasizes more frequently. Clinical differentiation of BSC and BCC is impossible owing to their clinical similarity. Dermoscopic patterns may facilitate early diagnosis and accurate management. Confirmation remains histological, showing areas typical for both BCC and SCC. Immunohistochemical examination may provide additional data for a more accurate diagnosis. Review of the literature reveals a metastatic rate greater than that of basal cell and squamous cell carcinoma, and identifies several important characteristics that impact prognosis after surgical resection. It’s important to have an early diagnosis and compulsory excision and a regular follow-up in order to avoid the significant morbidity and even mortality associated with this aggressive carcinoma of the skin.