Basal Cell Carcinosarcoma with an Osteosarcomatous Component: A Case Report Supporting the Diagnostic Utility of SATB2 and TRAP Immunostaining with a Literature Review of 22 Cases.
Erina Kodaka, Shiro Iino, Chinami Kishimoto et al.
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Case in brief
A 91-year-old woman presented with a rapidly enlarging solitary tumor on her left cheek, diagnosed as basal cell carcinosarcoma (BCCS) with a focal osteosarcomatous component. Histopathological analysis revealed a biphasic tumor with conventional basal cell carcinoma and a high-grade sarcomatous component. Immunohistochemical staining showed positivity for SATB2 and tartrate-resistant acid phosphatase, confirming the osteosarcomatous nature of the tumor.
What made this case unusual
This case is notable for the combined use of SATB2 and tartrate-resistant acid phosphatase immunostaining, which has not been previously reported in the context of cutaneous carcinosarcoma.
Diagnostic / clinical pearl
Clinicians should consider the potential for basal cell carcinosarcoma to exhibit an osteosarcomatous component, particularly in older patients with rapidly enlarging tumors.
Why it matters
The case underscores the importance of specific immunohistochemical markers, such as SATB2 and tartrate-resistant acid phosphatase, in accurately diagnosing and distinguishing osteosarcomatous components in carcinosarcoma.