This document provides an overview of basal cell carcinoma (BCC), including its definition, origin, types, gross pathology, histopathology, diagnosis, and treatment. It notes that BCC arises from pluripotential basal cells in the surface epithelium and adnexal structures. There are mainly four types of BCC - superficial, nodular, micronodular, and infiltrating. Intraoral BCC (IOBCC) can arise in the oral cavity, with nodular BCC being the most common type seen there. IOBCC is diagnosed through biopsy and immunohistochemistry staining, which is compared to oral proliferative verrucous leukoplakia (PA). Treatment involves wide local exc

1. BASAL CELL
CARCINOMA
BY MOEED URRAHMAN
KMU-IDS KOHAT
2014-19

2. Presentation outlines
 Definition
 Origin
 Types
 Gross Pathology
 Histopathology
 Diagnosis
 Treatment

3. Definition
An invasive malignant
neoplasm of basal cells

4. Origin
Bcc arise from
pluripotential basal cells
present within surface
epithelium and adnexal
structure

5. TYPES
Mainly four types
Superficial BCC
Nodular BCC
Micronodular BCC
Infiltrating BCC
 Less common are
Fibroepithelial BCC
Morpheiform BCC
Basosquamous Carcinoma

6. IOBCC
 well documented cases arise from the gingiva.
 Also present on dorsum of tongue
 soft & hard palate
 Rare entity
 In 2001, Del Rosario et al. reported the first well
documented case of IOBCC on the buccal mucosa
 Nodular BCC
 Arise with in oral cavity

7. Gross patholgy
Clinically IOBCC resemble carcinomas
typically presents as surface ulcerations
varying from rodent ulcer to an ulcerated
erythroplakia appearance
Papule or nodule
May or may not be associated with
telangiectasia

9. Histopathology

11. BCC

14. DIAGNOSIS

15.  Many of the early cases reported as
IOBCC actually represent PA
In order to diagnose
Comparison b/w IOBCC &
PA is necessary

16. IOBCC PA
Clinical Appears malignant- resembles carcinoma;
mixed red/white, maybe ulcerated
Appears benign: “bump
on the gum”
Origin Pluripotent basal cells in surface
epithelium and adnexal structures
Basal cells in surface
epithelium or dental
lamina rests
Microscopic features Budding of epithelial islands into lamina
propria
Prominent retraction artifact
Scattered mitotic figures
Apoptotic cells
Mucoid ground substance
Widely infiltrative throughout connective
tissue
Peripheral palisading but lacking apical
vacuolization & reverse polarity
May or may not have
connection to surface
epithelium
Little or no retraction artifact
Few to absent mitotic figures
Mucoid ground substance
Not significantly infiltrative
Islands of hyperchromatic
basaloid cells with peripheral
palisading, areas of stellate
reticulum, prominent reverse
polarity & apical vacuolization
Immunohistochemistry Positive Ber-EP4; Negative for EMA and
Calretinin
Negative Ber-EP4; Positive
EMA and Calretinin

17. BIOPSY
IMMUNOHISTOCHEMISTRY

18. Ber-EP4 EMA Calretinin
Case Positive Negative Negative
Immunohistochemical reactivity

19. Treatment

20. MEDICAL TREATMENT
 CYCLOPAMINE, A NATURALLY OCCURRING SUBSTANCE IN THE CORN LILY
PLANT
 INHIBIT THE FUNCTION OF THE HEDGEHOG PATHWAY

21. SURGICAL TREATMENT

22.  Wide local excision or resection appears
to be the treatment choice

23. Thank you