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Peritumoral retraction clefting in basal cell carcinoma of the skin

Peritumoral lacunas or peritumoral retraction clefting are frequently observed around buds of basal cell carcinomas (BCC) and appear as a clear halo on hematoxylin-eosin section. They were considered as technical artifacts related to fixation methods. However, they can be observed on frozen sections where there are no similar fixation artifacts. Peritumoral clefting of BCC may be considered as a good example of carcinoma-stroma interaction. The aim of the study was to analyze the presence of peritumoral clefting in different BCC types. The surgical pathology registry at Ljudevit Jurak University Department of Pathology was canvassed for the year 2003 to identify patients with skin BCC. Twenty-nine tumors were selected and further classified according to established histopathologic criteria as solid undifferentiated and adenoid differentiated. All relevant patient data including age, sex and histologic appearance were analyzed. There were 16 patients with adenoid and 13 patients with solid form of BCC. In the group with adenoid form there were eight males and females each, age range 48-89 (mean 67.9) years. In the group with solid form there were eight males and five females, age range 46-81 (mean 65.8) years. Tumor nests with more than 10 adenoid structures were analyzed. We also observed peritumoral clefting present in more or less than 50% of the adenoid structure circumference. All tumors were localized in the head and neck region. In the group of 13 solid BCCs there were three tumors with retraction clefting around complete circumference of the nests. Five tumors had less than 50% and five had more than 50% circumference included in retraction clefting. In the group of 16 adenoid BCC type there were two tumors in which there was clefting retraction around whole adenoid formation circumference. One tumor had less than 50% and thirteen had more than 50% circumference included in clefting retraction. We confirmed the existence of peritumoral retraction clefting in both solid and adenoid types of BCC. Clefting was found to be more pronounced in adenoid BCC type. Obviously, this phenomenon is due to the interaction between tumor cells and stroma, and should be additionally analyzed.

Basal cell carcinoma; peritumoral retraction clefting

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