Vol. 98  No. August 2005

Two Cases of Basaloid Squamous Cell 
Carcinoma of Pharynx

Masanao Kishimoto and Masaru Yamashita
(Kyoto University)
Makito Tanabe, Hideaki Ogita and Kimio Hashimoto
(Nishi-Kobe Medical Center)
Koichi Omori
(Fukushima Medical University)

      Basaloid squamous cell carcinoma (BSC) is an uncommon aggressive variant of squamous cell carcinoma (SCC). Association with SCC components is often identified as BSC's important cytologic feature. We treated two patients with BSC without association of SCC in the pharynx.
     Case 1 was a 42-year-old woman with left otalgia. A left tonsil tumor was suspected and incisional biopsy was performed. The diagnosis of the tumor was BSC (T3N0M0). Irradiation (40.8 Gy) with chemotherapy (Nedaplatin 100 mg) were not effective. Then tumor resection with mandibular swing and bilateral neck dissection was performed. The histopathological diagnoses were BSC and no metastatic lymph node was found. All surgical margins were negative (pT4N0). About 3 years after the tumor resection, there is no evidence of disease.
     Case 2 was a 56-year-old man with left lateral neck mass of 7 months' duration. Because the neck mass rapidly enlarged in the latest month, he visited the Nishi-kobe Medical Center. Clinical examination revealed a small exophytic mass in the left piriform sinus and two lateral neck masses (30 mm2), anterior and posterior to the internal jugular vein that were suspected to be metastatic lymph nodes. A twenty-seven mm mass in the liver was also found in the abdominal echo image. Fiberoptic biopsy from the left piriform sinus tumor, incisional biopsy from the lateral neck mass and needle biopsy from the liver mass were performed. Histopathological diagnosis was BSC in the left piriform sinus with lymph nodes and liver metastasis (T1N2bM1). The patient hoped to receive ambulatory peroral chemotherapy with TS-1? (100 mg/day). During the chemotherapy, bone metastasis was revealed. Palliative irradiation was effective to reduce bone and neck pain. The patient died due to the BSC about 1 year after diagnosis.

Key words : basaloid squamous cell carcinoma, pharynx, squamous cell carcinoma


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