Adenoid Basal Cell Carcinoma and its Mimics
A 55-year-old man reported a slow-growing nodule on the right side of the nose since 3 years. The lesion had gradually increased to a size of 3.5 cm diameter when he reported to the Surgical Outpatient Department with complaints of ulceration of the nodule and superficial bleeding since the last 10 days []. The patient was a casual laborer by profession, which involved long hours of sun exposure. On examination, the regional lymph nodes were not enlarged and his general physical condition was stable. The clinical impression was of an ulcerated BCC, and the patient was taken up for a wide local excision of the ulcerated nodular mass. Gross examination showed a raised nodule with a thin rim of skin at the periphery. It showed a central ulcer with crusting and irregular rolled borders. Histological picture showed a predominant adenoid pattern with thin strands of basaloid cells in a reticulate arrangement, with many tubules and few cystically dilated spaces containing mucin []. Peripheral palisading of the basaloid cells was seen in some of the islands along with retraction artefact of the surrounding stroma and connection to the overlying epidermis was evident. Immunohistochemical studies were carried out and staining with anti-bcl-2 monoclonal antibody showed homogenous cytoplasmic staining throughout the lesion []. Staining for S-100, epithelial membrane antigen (EMA), carcinoembryonic antigen (CEA) and cytokeratin (CK-7) were done, and were found to be negative.