Basaloid squamous cell carcinoma of the head and neck

Objective/Hypothesis: Basaloid squamous cell carcinoma (BSCC), an uncommon tumor with predilection for the upper aerodigestive tract, is a distinct va riant of squamous carcinoma, because of its unique histological features an d ominous clinical behavior. This study reviews the experience in treating BSCC from two institutions. Study Design: Retrospective. Methods: H&E-stain ed sections from 20 patients with BSCC of the head and neck were reviewed a nd clinical follow-up was obtained for all patients. Results: The study gro up consisted of 14 male and 6 female patients. Their ages ranged from 43 to 85 years, with a mean age of 62 years. Sites of origin included the larynx (4), tongue (3), pyriform sinus (3), nose (2), floor of mouth (2), mastoid (1), tonsil (1), epiglottis (1), nasopharynx (1), trachea (1), and palate (1), Pain was the most common presenting symptom (5 cases), followed by hoa rseness and bleeding (3 cases each). Tobacco and alcohol abuse was noted in 17 patients. Treatment modalities included surgery with or without chemoth erapy or radiotherapy in 13 patients, chemotherapy with irradiation in 2, c hemotherapy alone in 2, and radiotherapy alone in 3, Clinical follow-up rev ealed no evidence of disease in 11 patients. Four were alive with disease a t the time of writing and five died of disease. Conclusion: BSCC is a highl y aggressive malignant tumor that presents in elderly patients who have a h istory of abuse of tobacco or alcohol, or both. Greater number of patients must be studied and compared with age-matched and stage-matched controls of conventional squamous cell carcinoma to determine whether the poor clinica l outcome is related more to high-stage presentation or to the tumor's high -grade malignant cytological features.