Colliding, colonizing or combining? Four cases illustrating the unique challenges presented by melanoma arising in conjunction with basal cell carcinoma

Journal of Cutaneous Pathology
Matthew DinehartSara C Shalin

Abstract

Biphasic lesions comprised of melanocytic and epithelial components are rare entities believed to arise either as a collision of 2 histologically distinct lesions in the same anatomic location or as a singular progenitor tumor differentiating along 2 differing lineages. Regardless of mechanism of origin, these tumors present unique challenges in pathologic interpretation and in determining appropriate measurements, which assigns subsequent prognosis to the patient. We present 4 tumors of melanoma co-existing with basal cell carcinoma (BCC) and discuss relevant literature regarding these biphasic entities. Patients consisted of 3 males and 1 female, ranging in age from 62 to 93, with lesions located on the shoulder, frontal scalp, forearm and nose. Three of 4 lesions showed melanoma cells limited to BCC tumor lobules, without evidence of direct dermal invasion by melanoma cells, raising the question of whether or not these tumors should be classified as in situ or invasive melanoma. These cases highlight the complexity that such lesions pose to dermatopathologists, in terms of their uncertain origin and variable microscopic appearance. In the absence of data regarding outcomes for these tumors (given their rarity), it is importa...Continue Reading

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Citations

May 15, 2019·The American Journal of Dermatopathology·Duygu GülserenAlejandro A Gru
Nov 7, 2019·The American Journal of Dermatopathology·Michael P RyanBrent C Kelly
Sep 30, 2020·Journal of Cutaneous Pathology·Manuel Pérez-PérezJuan J Ríos-Martín
Aug 28, 2020·Dermatologic Therapy·Camille A BulteAmor Khachemoune
Dec 21, 2021·The Australasian Journal of Dermatology·Raúl CabreraFrancisca Reculé
Dec 22, 2021·Journal of the European Academy of Dermatology and Venereology : JEADV·M T Fernández-FiguerasUNKNOWN Study Group Collaborators (Validation Group)

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