Basal cell carcinoma nodular - Altmeyers Encyclopedia

Synonym(s)

cystic basal cell carcinoma; Solid basal cell carcinoma; solid basalioma

Definition
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Basal cell carcinoma histologically consisting of compact tumor cell collections with marginally palisaded cells, without differentiation of structures of the skin appendages. Clinically mostly as nodular or nodulo-ulcerous basal cell carcinoma.

Clinical features
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The clinical picture of solid basal cell carcinoma corresponds to nodular basal cell carcinoma (see below Basal cell carcinoma, nodular).
Initially small, skin-colored, waxy shiny, coarse, painless nodule with fine telangiectasias covering the edge of the nodule. Slow growth, possibly formation of multiple aggregated nodules. Central depression and atrophy, eventually ulceration. Development of an ulcer with a marginal wall consisting of shiny papules (pearly), so-called ulcus rodens.
Some of the solid BCCs show an irregular pigmentation, whereby the pigment (melanin) can show brown but also blue tones (depending on the location of the pigment accumulation, see also basal cell carcinoma, pigmented), recognizable by light microscopy as 'ovoid pigment nests'.

Histology
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Intense basophilic, solid epithelial strands consisting of largely uniform, cytoplasmic, basaloid cells with roundish to oval, partly also spindle, basophilic nuclei, which form palisade-like at the edges, while the inner tumor parts remain largely unstructured (see Abbott basal cell carcinoma, nodular or nodulo-ulcerous). The tumour convolutes are embedded in a compact, fibrous, connective tissue stroma. The cystic-vacuolated gaps between the tumour parenchyma and the tumour stroma, which are always present in this type of BCC, are of differential diagnostic value. In some BCC cystic degeneration foci with formation of cystic cavities occur (see also basal cell carcinoma, cystic).