Basal Cell Carcinoma With Ductal Differentiation Presenting as a Large Unilocular Cyst on the Abdomen.
Atsushi Naito, Kodai Furuta, Takaya Fukumoto et al.
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Case in brief
An 83-year-old Japanese man presented with a large unilocular cyst on the abdomen, initially suspected to be a sweat gland neoplasm based on a punch biopsy. Complete excision revealed the cyst was continuous with a basaloid tumor consistent with basal cell carcinoma (BCC), characterized by peripheral palisading and partial BerEP4 expression. The cyst lining was EMA-positive, confirming it as a genuine cyst.
What made this case unusual
The case highlights a rare presentation of basal cell carcinoma with ductal differentiation manifesting as a large unilocular cyst, which is uncommon in the literature.
Diagnostic / clinical pearl
Clinicians should consider basal cell carcinoma in the differential diagnosis of cystic lesions, especially when immunohistochemical analysis reveals atypical features.
Why it matters
This case underscores the necessity of thorough excision and detailed histopathological evaluation to prevent misdiagnosis of cystic lesions.