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Basaloid morphology is frequently encountered in squamous cell carcinomas (SCC) of the head and neck and is associated with both smoking-related and human papillomavirus-driven tumors. Unlike conventional morphology SCC, the basaloid variant of SCC can mimic a wide variety of other head and neck malignancies including salivary gland tumors (adenoid cystic carcinoma [ACC], basal cell adenocarcinoma), small cell cancers (Epstein-Barr virus-associated nasopharyngeal carcinoma, sinonasal undifferentiated carcinoma, neuroendocrine carcinoma, primitive neuroectodermal tumor, NUT-midline carcinoma), melanoma, and, occasionally, sarcomas (mesenchymal chondrosarcoma, rhabdomyosarcoma, synovial sarcoma). These alternative diagnoses can be excluded with careful attention to morphology and, when necessary, immunohistochemical protein expression patterns. We present a case of smoking-related basaloid SCC and discuss this differential diagnosis.
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Mills et al. (2011) studied this question.
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