Track

Case Reports

Abstract

A 72 year old female presented with a 2.5 cm ulcerated tumor of the right inguinal fold.  Biopsy revealed a basaloid proliferation which had the appearance of a primary cutaneous basal cell carcinoma or basosquamous cell carcinoma.  The clinician then indicated the patient had a history of rectal carcinoma.  The original anal/rectal tumor was shown to be a basaloid squamous cell carcinoma upon review of the previous rectal biopsy.  A well-controlled SOX-2 immunoperoxidase reaction of the right inguinal fold skin biopsy showed diffuse strong SOX-2 expression confirming the diagnosis of metastatic anal basaloid squamous cell carcinoma to the skin.  Anal malignancies are rare, and of these squamous cell carcinoma is the most common type. Anal basaloid squamous cell carcinoma are HPV related and reported more frequently in elderly females.  They are usually located in the transitional cloacogenic zone of the anus (cloacogenic carcinoma).  Anal basaloid squamous cell carcinomas are aggressive tumors with a tendency to recur and metastasize to regional lymph nodes. They are often treated with chemoradiation therapy with or without surgery. To our knowledge there are only three other reported cases of cutaneous metastases of primary anal basaloid squamous cell carcinoma.  Although rare, dermatopathologists should be aware of this entity which closely mimicks a primary cutaneous basal cell carcinoma.