Zusammenfassung
Hintergrund und Fragestellung
Das basaloide Plattenepithelkarzinom wird seit der Aufnahme in die WHO-Tumorklassifikation immer häufiger als seltene hochmaligne Variante der Plattenepithelkarzinome erkannt; seine typische Lokalisation ist im Bereich von Zungengrund, supraglottischer Region und Sinus piriformis zu finden. Aufgrund des ausgeprägt submukösen Wachstums, der Tendenz zur Tiefeninfiltration sowie der frühen Bildung von Lokal- und Fernmetastasen wird die Diagnose meist erst in einem weit fortgeschrittenen Erkrankungsstadium gestellt.
Patienten und Methodik
Der vorgestellte Fall eines 39-jährigen Mannes zeigt die für diese Erkrankung typischen klinischen und histopathologischen Befunde.
Ergebnisse
Im Gegensatz zum gewöhnlichen Plattenepithelkarzinom sollte beim basaloiden Plattenepithelkarzinom wegen der sehr schlechten Prognose die Lebensqualität bei therapeutischen Entscheidungen eine besondere Berücksichtigung finden. Vor allem lassen die hohe Lokalrezivquote und die frühe Fernmetastasenbildung eine hohe chirurgische Invasivität nur in Ausnahmefällen gerechtfertigt erscheinen.
Schlussfolgerung
Wie auch im vorliegenden Fall haben neben der Chirurgie auch radiochemotherapeutische Ansätze eine besondere Bedeutung.
Abstract
Background and objective
Basaloid squamous cell carcinoma s a rare, highly malignant carcinoma variant typically situated in the tongue base, supraglottis and pyriform sinus. It is usually only diagnosed at a very advanced stage due to its tendency towards submucosal growth, deep infiltration and early local and distant metastases.
Patients/Methods
The case described involves a 39-year-old man with the clinical and histopathological findings typical for this neoplasm.
Results
In contrast to simple squamous cell carcinomas, the basaloid variant with its very poor prognosis calls for therapeutic decisions that give particular consideration to quality of life. It should be stressed that highly invasive surgery is justified only in exceptional cases because of the high local recurrence rate and early distant metastases.
Conclusions
The case presented shows that radio- and chemotherapeutic approaches are just as important as surgery.
This is a preview of subscription content, log in via an institution to check access.
Literatur
Banks ER, Frierson HF Jr, Mills SE et al. (1992) Basaloid squamous cell carcinoma of the head and neck. A clinicopathologic and immunohistochemical study of 40 cases. Am J Surg Pathol 16: 939–946
Cadier MA, Kelly SA, Parkhouse N, Brough MD (1992) Basaloid squamous carcinoma of the buccal cavity. Head Neck 14: 387–391
Campman SC, Gandour-Edwards RF, Sykes JM (1994) Basaloid squamous carcinoma of the head and neck. Report of a case occurring in the anterior floor of the mouth. Arch Pathol Lab Med 118: 1229–1232
Cho KJ, Jang JJ, Lee SS, Zo JI (2000) Basaloid squamous carcinoma of the oesophagus: a distinct neoplasm with multipotential differentiation. Histopathology. 36: 331–340
Erdamar B, Suoglu Y, Sirin M, Karatay C, Katircioglu S, Kiyak E (2000) Basaloid squamous cell carcinoma of the supraglottic larynx. Eur Arch Otorhinolaryngol 257: 154–157
Ferlito A, Altavilla G, Rinaldo A, Doglioni C (1997) Basaloid squamous cell carcinoma of the larynx and hypopharynx. Ann Otol Rhinol Laryngol 106: 1024–1035
Larner JM, Malcolm RH, Mills SE et al. (1993) Radiotherapy for basaloid squamous cell carcinoma of the head and neck. Head Neck 15: 249–252
Mills SE, Gaffey MJ, Frierson HF (2000) Tumors of the upper aerodigestive tract and ear. Squamous Cell Carcinoma Variants. In: Rosai J, Sobin LH (eds) Atlas of tumor pathology. Third series. Fascicle 26. Armed Forces Institute of Pathology, Washington DC, pp 80–85
Morice WG, Ferreiro JA (1998) Distinction of basaloid squamous cell carcinomas from adenoid cystic and small cell undifferentiated carcinomas by immuno-histochemistry. Hum Pathol 29: 609–612
Müller E, Beleites E (2000) the basaloid squamous cell carcinoma of the nasopharynx. Rhinology 38: 208–211
Paulino AF, Singh B, Shah JP, Huvos AG (2000) Basaloid squamous cell carcinoma of the head and neck. Laryngoscope 110: 1479–1482
Seidman JD, Berman JJ, Yost BA, Iseri OA (1991) Basaloid squamous carcinoma of the hypopharynx and larynx associated with second primary tumors. Cancer 68: 1545–1549
Sheen TS, Chang YL, Ko JY, Wu CT, Lee SY (1999) Basaloid squamous cell carcinoma of the larynx. Arch Otolaryngol Head Neck Surg 121: 647–650
Tsang WY, Chan JK, Lee KC, Leung AK, Fu YT (1991) Basaloid-squamous carcinoma of the upper aerodigestive tract and so-called adenoid cystic carcinoma of the oesophagus: the same tumour type? Histopathology 19/1: 35–46
Wain SL, Kier R, Vollmer RT, Bossen EH (1986) Basaloid-squamous carcinoma of the tongue, hypopharynx, and larynx: report of 10 cases. Hum Pathol 17: 1158–1166
Wan SK, Chan JK, Lau WH, Yip TT (1995) Basaloid-squamous carcinoma of the nasopharynx. An Epstein-Barr virus-associated neoplasm compared with morphologically identical tumors occurring in other sites. Cancer 76: 1689–1693
Wan SK, Chan JK, Tse KC (1992) Basaloid-squamous carcinoma of the nasal cavity. J Laryngol Otol 106: 370–371
Wieneke JA, Heffner DK (2000) Basaloid squamous cell carcinoma: an aggressive variant of squamous cell carcinoma of the head and neck region. Path Case Rev 5: 200–205
Wieneke JA, Thompson LD, Wenig BM (1999) Basaloid squamous cell carcinoma of the sinonasal tract. Cancer 85: 841–854
World Health Organization (1991) Histological Typing of Tumours of the Upper Respiratory Tract and Ear. Springer, Berlin Heidelberg New York Tokio, S 31
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Helling, K., Loddenkemper, C. & Scherer, H. Therapeutische und histologische Besonderheiten des basaloiden Plattenepithelkarzinoms. HNO 51, 993–997 (2003). https://doi.org/10.1007/s00106-003-0811-4
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00106-003-0811-4