Basal cell carcinosarcoma: a report of 4 cases and review of the literature.
BACKGROUND
To describe the features of 4 cases of basal cell carcinosarcoma and systematically review previously reported cases.


METHODS
Four cases of basal cell carcinosarcoma were identified from the practice of the authors. A search of the literature revealed an additional 40 cases, variously described in small series and single case reports. The clinical and pathological features of these 44 cases are described.


RESULTS
Basal cell carcinosarcoma is largely a tumor of elderly men (male:female 3:1, average age: 76 years). The majority of these lesions are relatively small (<25 mm). Heterologous elements are common, particularly an osteosarcomatous component, which is present in 45% of cases. Although there are relatively limited follow-up data, only 1 case formally reported in the literature has shown distant metastasis.


CONCLUSIONS
Despite relatively high reported rates of local recurrence and metastasis for "carcinosarcoma" as an unrefined entity, it seems that the subgroup of basal cell carcinosarcoma has a relatively good prognosis, with adequate local excision being curative in the majority of cases. Recognition of this entity is critical for accurate diagnosis and its separation from other types of carcinosarcoma may have significant prognostic implications.
*Department of Anatomical Pathology, PathWest Laboratory Medicine, QEII Medical Centre, Nedlands, Australia; †School of Pathology and Laboratory Medicine, University of Western Australia, Perth, Australia; ‡CliniPath Pathology, West Perth, Australia; §Healthscope Pathology, Queensland, Australia; and ¶Dermatopathology WA, Cottesloe, Australia.
Nathan T
NT
Harvey
Alka
A
Sinha
Daniel C
DC
Houghton
Trevor W
TW
Beer
Fiona J
FJ
Kingston
Lawrence
L
Yu
Benjamin A
BA
Wood
D000368:Aged; D000369:Aged, 80 and over; D002296:Carcinosarcoma / Q000473:pathology*; D006801:Humans; D008297:Male; D012878:Skin Neoplasms / Q000473:pathology*