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Multiple Hereditary Infundibulocystic Basal Cell Carcinomas
A Genodermatosis Different From Nevoid Basal Cell Carcinoma Syndrome
Luis Requena, MD;
Maria del Carmen Fariña, MD;
Mercedes Robledo, MD;
Omar P. Sangueza, MD;
Evaristo Sanchez Yus, MD;
Aurora Villanueva, MD;
Amparo Marquina, MD;
Roser Tamarit, MD
Arch Dermatol. 1999;135:1227-1235.
Background Infundibulocystic basal cell carcinoma is a recently described distinctive clinicopathologic variant of basal cell carcinoma. Histopathologic differential diagnosis among infundibulocystic basal cell carcinoma, trichoepithelioma, and basaloid follicular hamartoma has generated controversy in the literature.
Observations Members of 2 families with multiple infundibulocystic basal cell carcinomas are described. Each patient showed multiple papular lesions, mostly located on the face. No patient showed palmar pits or jaw cysts. Forty-two cutaneous lesions from 5 patients were studied histopathologically. Thirty-nine lesions were infundibulocystic basal cell carcinomas. This clinicopathologic variant of basal cell carcinoma consists of a relatively well-circumscribed basaloid neoplasm composed of buds and cords of neoplastic cells arranged in anastomosing fashion and with scant stroma. Some of the neoplastic cords contain tiny infundibular cysts filled by cornified cells with abundant melanin. Linkage analysis in family 2 was performed using polymorphic markers (D9S196, D9S280, D9S287, and D9S180), and the affected members shared the same haplotype. Loss of heterozygosity analysis was performed in 2 affected members of this family from whom tumoral DNA was available, and although these individuals were constitutively heterozygous for D9S196, they did not show loss of heterozygosity for this marker in their neoplasms.
Conclusions Multiple hereditary infundibulocystic basal cell carcinomas represent a distinctive genodermatosis different from multiple hereditary trichoepitheliomas and nevoid basal cell carcinoma syndrome. We propose clinical and histopathologic criteria to distinguish infundibulocystic basal cell carcinoma from trichoepithelioma, basaloid follicular hamartoma, and folliculocentric basaloid proliferation.
From the Departments of Dermatology (Drs Requena and Fariña) and Genetics (Dr Robledo), Fundación Jiménez Díaz, Universidad Autónoma, and the Department of Dermatology, Hospital Clínico San Carlos, Universidad Complutense (Dr Yus), Madrid, Spain; the Departments of Dermatology and Pathology, Medical College of Georgia, Augusta (Dr Sangueza); and the Departments of Pathology (Dr Villanueva) and Dermatology (Drs Marquina and Tamarit), Hospital Universitario Dr Peset, Valencia, Spain.
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Arch Dermatol. 1999;135(10):1282-1283.
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