Basal Cell Carcinoma Type Based on Histopathological Examination: Aggressive vs. Non-Aggressive
DOI:
10.29303/jppipa.v11i11.13073Published:
2025-11-25Downloads
Abstract
Histopathological subtypes of basal cell carcinoma (BCC) help determine prognosis and guide management. This study aimed to describe and compare the clinical and histopathological characteristics of aggressive and nonaggressive BCC. An observational descriptive study was conducted on 26 patients with biopsy-proven BCC. Hematoxylin and eosin (H&E) –stained sections were reviewed by an experienced pathologist. The nonaggressive group included nodular and superficial BCC, while the aggressive group included infiltrative and morpheaform BCC. Clinical and demographic data were recorded, and representative images were selected. Of the 26 cases, 13 were classified as aggressive and 13 as nonaggressive BCC. Female predominance was observed in both groups (61.54% vs. 69.24%). The mean age was 62.08 years in the aggressive group and 69.23 years in the nonaggressive group. Lesions were most frequently located in the nasal and zygomatic regions. The nodular subtype predominated among nonaggressive BCC (76.92%), while infiltrative (53.85%) and morpheaform (46.15%) subtypes were most common in the aggressive group. Histologically, nonaggressive subtypes exhibited well-circumscribed basaloid nests with palisading, whereas aggressive subtypes showed irregular cords within desmoplastic stroma and ill-defined margins. Histopathological examination remains the gold standard for differentiating aggressive from nonaggressive BCC, providing essential guidance for surgical planning and recurrence prevention.
Keywords:
Aggressive Basal Cell carcinoma Histopathological subtypes NonaggressiveReferences
Amici, J.-M., Dousset, L., Battistella, M., Vergier, B., Bailly, J.-Y., Cogrel, O., Gusdorf, L., Alfaro, C., Ezzedine, K., Cribier, B., & Beylot-Barry, M. (2021). Clinical factors predictive for histological aggressiveness of basal cell carcinoma: A prospective study of 2274 cases. Annales de Dermatologie et de Vénéréologie, 148(1), 23–27. https://doi.org/10.1016/j.annder.2019.10.028 DOI: https://doi.org/10.1016/j.annder.2019.10.028
Anggraini, E., & Damayanti, P. A. A. (2024). Ascorbic Acid Injection Efficacy to Increase Skin Collagen. Jurnal Penelitian Pendidikan IPA, 10(6), 3449–3454. https://doi.org/10.29303/jppipa.v10i6.5282 DOI: https://doi.org/10.29303/jppipa.v10i6.5282
Baba, P. U., Hassan, A. U., Khurshid, J., & Wani, A. H. (2024). Basal Cell Carcinoma: Diagnosis, Management and Prevention. In Journal of Molecular Pathology (Vol. 5, Issue 2, pp. 153–170). https://doi.org/10.3390/jmp5020010 DOI: https://doi.org/10.3390/jmp5020010
Bassukas, I. D., & Tatsioni, A. (2019). Male Sex is an Inherent Risk Factor for Basal Cell Carcinoma. Journal of Skin Cancer, 2019(1), 8304271. https://doi.org/10.1155/2019/8304271 DOI: https://doi.org/10.1155/2019/8304271
Camela, E., Ilut Anca, P., Lallas, K., Papageorgiou, C., Manoli, S.-M., Gkentsidi, T., Eftychidou, P., Liopyris, K., Sgouros, D., Apalla, Z., & Lallas, A. (2023). Dermoscopic Clues of Histopathologically Aggressive Basal Cell Carcinoma Subtypes. In Medicina, 50(2), 349. https://doi.org/10.3390/medicina59020349 DOI: https://doi.org/10.3390/medicina59020349
Ciążyńska, M., Sławińska, M., Kamińska-Winciorek, G., Lange, D., Lewandowski, B., Reich, A., Pabianek, M., Szczepaniak, K., Hankiewicz, A., Ułańska, M., Morawiec, J., Błasińska-Morawiec, M., Morawiec, Z., Piekarski, J., Brodowski, R., Zaryczańska, A., Sobjanek, M., Owczarek, W., Słowińska, M., … Lesiak, A. (2020). Clinical and epidemiological analysis of basosquamous carcinoma: results of the multicenter study. Scientific Reports, 10(1), 18475. https://doi.org/10.1038/s41598-020-72732-x DOI: https://doi.org/10.1038/s41598-020-72732-x
Collier, N. J., & Rhodes, L. E. (2020). Photodynamic Therapy for Basal Cell Carcinoma: The Clinical Context for Future Research Priorities. In Molecules 25(22), 5398). https://doi.org/10.3390/molecules25225398 DOI: https://doi.org/10.3390/molecules25225398
Dai, J., Lin, K., Huang, Y., Lu, Y., Chen, W.-Q., Zhang, X.-R., He, B.-S., Pan, Y.-Q., Wang, S.-K., & Fan, W.-X. (2018). Identification of critically carcinogenesis-related genes in basal cell carcinoma. OncoTargets and Therapy, 11(null), 6957–6967. https://doi.org/10.2147/OTT.S170504 DOI: https://doi.org/10.2147/OTT.S170504
De Giorgi, V., Savarese, I., Gori, A., Scarfi, F., Topa, A., Trane, L., Portelli, F., Innocenti, A., & Covarelli, P. (2020). Advanced basal cell carcinoma: when a good drug is not enough. Journal of Dermatological Treatment, 31(6), 552–553. https://doi.org/10.1080/09546634.2018.1542481 DOI: https://doi.org/10.1080/09546634.2018.1542481
Dika, E., Scarfì, F., Ferracin, M., Broseghini, E., Marcelli, E., Bortolani, B., Campione, E., Riefolo, M., Ricci, C., & Lambertini, M. (2020). Basal Cell Carcinoma: A Comprehensive Review. In International Journal of Molecular Sciences, 21(15), 5572. https://doi.org/10.3390/ijms21155572 DOI: https://doi.org/10.3390/ijms21155572
Fotiadou, C., Apalla, Z., & Lazaridou, E. (2021). Basosquamous Carcinoma: A Commentary. In Cancers, 13(23), 6146. https://doi.org/10.3390/cancers13236146 DOI: https://doi.org/10.3390/cancers13236146
Heibel, H. D., Hooey, L., & Cockerell, C. J. (2020). A Review of Noninvasive Techniques for Skin Cancer Detection in Dermatology. American Journal of Clinical Dermatology, 21(4), 513–524. https://doi.org/10.1007/s40257-020-00517-z DOI: https://doi.org/10.1007/s40257-020-00517-z
Irawan, D., Ramadhan, K., & Azhar, A. (2022). Design of PCF-SPR for Early Detection of Skin Cancer Infected Cells. Jurnal Penelitian Pendidikan IPA, 8(5), 2293–2298. https://doi.org/10.29303/jppipa.v8i5.2120 DOI: https://doi.org/10.29303/jppipa.v8i5.2120
Johnson Noah R., T. M. . S. (2020). Mohs Surgery versus Standard Local Excision for Basal Cell Carcinoma, Squamous Cell Carcinoma, and Melanoma Skin Cancer. Facial Plast Surg, 36(02), 133–140. https://doi.org/10.1055/s-0040-1709142 DOI: https://doi.org/10.1055/s-0040-1709142
Kasumagic-Halilovic, E., Hasic, M., & Ovcina-Kurtovic, N. (2019). A Clinical Study of Basal Cell Carcinoma. Medical Archives (Sarajevo, Bosnia and Herzegovina), 73(6), 394–398. https://doi.org/10.5455/medarh.2019.73.394-398 DOI: https://doi.org/10.5455/medarh.2019.73.394-398
Khalil, A. A., Enezei, H. H., Aldelaimi, T. N., & Mohammed, K. A. (2024). Advances in Diagnosis and Treatment of Basal Cell Carcinoma. Journal of Craniofacial Surgery, 35(2). Retrieved from https://journals.lww.com/jcraniofacialsurgery/fulltext/2024/03000/advances_in_diagnosis_and_treatment_of_basal_cell.120.aspx DOI: https://doi.org/10.1097/SCS.0000000000009959
Kim, R. Y., Ward, B. B., & Zide, M. F. (2022). Head and Neck Skin Cancer BT - Peterson’s Principles of Oral and Maxillofacial Surgery (M. Miloro, G. E. Ghali, P. E. Larsen, & P. Waite (eds.); pp. 1081–1113). Springer International Publishing. https://doi.org/10.1007/978-3-030-91920-7_36 DOI: https://doi.org/10.1007/978-3-030-91920-7_36
Knecht-Gurwin, K., Stefaniak, A. A., Chlebicka, I., & Szepietowski, J. C. (2024). Basal Cell Carcinoma: Comprehensive Review with Emphasis on Scar Tissue Manifestation and Post-Vaccination Incidence. In Biomedicines (Vol. 12, Issue 8, p. 1769). https://doi.org/10.3390/biomedicines12081769 DOI: https://doi.org/10.3390/biomedicines12081769
Li, C.-L., Chen, Y.-C., Yang, K.-C., & Chen, L.-W. (2020). Different histopathologic profiles and outcomes between sun-exposed BCC and non-sun-exposed BCC. Scientific Reports, 10(1), 7387. https://doi.org/10.1038/s41598-020-64391-9 DOI: https://doi.org/10.1038/s41598-020-64391-9
Murgia, G., Denaro, N., Boggio, F., Nazzaro, G., Benzecry, V., Bortoluzzi, P., Passoni, E., Garrone, O., & Marzano, A. (2023). Basosquamous Carcinoma: Comprehensive Clinical and Histopathological Aspects, Novel Imaging Tools, and Therapeutic Approaches. In Cells (Vol. 12, Issue 23, p. 2737). https://doi.org/10.3390/cells12232737 DOI: https://doi.org/10.3390/cells12232737
Murray, Christian, Sivajohanathan, Duvaraga, Hanna, Timothy P, Bradshaw, Scott, Solish, Nowell, Moran, Benvon, Hekkenberg, Robert, Wei, Alice C, & Petrella, Teresa. (2018). Patient Indications for Mohs Micrographic Surgery: A Systematic Review. Journal of Cutaneous Medicine and Surgery, 23(1), 75–90. https://doi.org/10.1177/1203475418786208 DOI: https://doi.org/10.1177/1203475418786208
Naik, P. P., & Desai, M. B. (2022). Basal Cell Carcinoma: A Narrative Review on Contemporary Diagnosis and Management. Oncology and Therapy, 10(2), 317–335. https://doi.org/10.1007/s40487-022-00201-8 DOI: https://doi.org/10.1007/s40487-022-00201-8
Nicer, J., Kania, J., Nicer, K., Sobol, M., Jurkiewicz, D., & Rot, P. (2025). Basal Cell Carcinoma in the Head and Neck Area: Radicality of Tumour Removal Considering its Type. Dermatology Review/Przegląd Dermatologiczny, 112(3), 141–149. https://doi.org/10.5114/dr.2025.154364 DOI: https://doi.org/10.5114/dr.2025.154364
Niculet, E., Radaschin, D. S., Arbune, M., Bobeica, C., Craescu, M., Onisor, C., Gurau, G., Busila, C., Vasile, C. I., & Tatu, A. L. (2024). Basal Cell Carcinoma Cleft: The Missing Piece of the Puzzle. Cureus, 16(10), 1–9. https://doi.org/10.7759/cureus.71244 DOI: https://doi.org/10.7759/cureus.71244
Oldbury, J. W., Wain, R. A. J., Abas, S., Dobson, C. M., & Iyer, S. S. (2018). Basosquamous Carcinoma: A Single Centre Clinicopathological Evaluation and Proposal of an Evidence-Based Protocol. Journal of Skin Cancer, 2018(1), 6061395. https://doi.org/10.1155/2018/6061395 DOI: https://doi.org/10.1155/2018/6061395
Pampena, R., Parisi, G., Benati, M., Borsari, S., Lai, M., Paolino, G., Cesinaro, A. M., Ciardo, S., Farnetani, F., Bassoli, S., Argenziano, G., Pellacani, G., & Longo, C. (2021). Clinical and Dermoscopic Factors for the Identification of Aggressive Histologic Subtypes of Basal Cell Carcinoma. Frontiers in Oncology, Volume 10-2020. Retrieved from https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2020.630458 DOI: https://doi.org/10.3389/fonc.2020.630458
Papadopoulos, O., Karantonis, F.-F., & Papadopulos, N. A. (2020). Non-melanoma Skin Cancer and Cutaneous Melanoma for the Plastic and Reconstructive Surgeon BT - Non-Melanoma Skin Cancer and Cutaneous Melanoma: Surgical Treatment and Reconstruction (O. Springer International Publishing. https://doi.org/10.1007/978-3-030-18797-2_6 DOI: https://doi.org/10.1007/978-3-030-18797-2
Paul, S., & Knight, A. (2023). The Importance of Basal Cell Carcinoma Risk Stratification and Potential Future Pathways. JMIR Dermatol, 6, e50309. https://doi.org/10.2196/50309 DOI: https://doi.org/10.2196/50309
Pyne, J. H., Myint, E., Hou, R., Clark, S. P., Wong, C., & Gorji, M. (2020). Basal cell carcinoma with perineural invasion: A prospective study examining subtype, tumor surface diameter, invasion depth, and anatomic site in 3005 consecutive cases. Journal of Cutaneous Pathology, 47(11), 1033–1038. https://doi.org/10.1111/cup.13808 DOI: https://doi.org/10.1111/cup.13808
Reiter, O., Mimouni, I., Dusza, S., Halpern, A. C., Leshem, Y. A., & Marghoob, A. A. (2021). Dermoscopic features of basal cell carcinoma and its subtypes: A systematic review. Journal of the American Academy of Dermatology, 85(3), 653–664. https://doi.org/10.1016/j.jaad.2019.11.008 DOI: https://doi.org/10.1016/j.jaad.2019.11.008
Schmults, C. D., Blitzblau, R., Aasi, S. Z., Alam, M., Amini, A., Bibee, K., Bordeaux, J., Chen, P. L., Contreras, C. M., DiMaio, D., Donigan, J. M., Farma, J. M., Ghosh, K., Harms, K., Ho, A. L., Lukens, J. N., Mark, L., Medina, T., Nehal, K. S., … Espinosa, S. (2023). Basal Cell Skin Cancer, Version 2.2024. JNCCN Journal of the National Comprehensive Cancer Network, 21(11), 1181–1203. https://doi.org/10.6004/jnccn.2023.0056 DOI: https://doi.org/10.6004/jnccn.2023.0056
Shi-Qi, W., Jie, L., Tao, Q., Kai, F., & Hong-Zhong, J. (2022). Dermoscopic Features of Basal Cell Carcinoma and Their Association with Histological Types in A Chinese Population: A Perspective Study. International Journal of Dermatology and Venereology, 05(02), 68–74. https://doi.org/10.1097/JD9.0000000000000194 DOI: https://doi.org/10.1097/JD9.0000000000000194
Tanese, K. (2019). Diagnosis and Management of Basal Cell Carcinoma. Current Treatment Options in Oncology, 20(2), 13. https://doi.org/10.1007/s11864-019-0610-0 DOI: https://doi.org/10.1007/s11864-019-0610-0
Trieu, K. G., Tsai, S.-Y., Eberl, M., Ju, V., Ford, N. C., Doane, O. J., Peterson, J. K., Veniaminova, N. A., Grachtchouk, M., Harms, P. W., Swartling, F. J., Dlugosz, A. A., & Wong, S. Y. (2022). Basal cell carcinomas acquire secondary mutations to overcome dormancy and progress from microscopic to macroscopic disease. Cell Reports, 39(5). https://doi.org/10.1016/j.celrep.2022.110779 DOI: https://doi.org/10.1016/j.celrep.2022.110779
Venturi, F., Magnaterra, E., Scotti, B., Alessandrini, A., Veneziano, L., Vaccari, S., Baraldi, C., & Dika, E. (2025). Squamous Cell Carcinoma of the Nail Unit: A Comprehensive Review of Clinical Features, Diagnostic Workflow, Management Strategies and Therapeutic Options. In Diagnostics, 15(18), 2378). https://doi.org/10.3390/diagnostics15182378 DOI: https://doi.org/10.3390/diagnostics15182378
Vornicescu, C., Melincovici, C. S., Soriţău, O., Şenilă, S. C., & Mihu, C. M. (2018). Basal cell carcinoma: Review of etiopathogenesis, diagnosis and management. Human and Veterinary Medicine, 10(1), 1–9. Retrieved from https://hvm.bioflux.com.ro/docs/2018.1-9a.pdf
WHO. (2018). WHO Classification of Tumors. World Health Organization. Retrieved from https://whobluebooks.iarc.who.int/structures/skintumours/
Winaya, K. K., Primandita, M. S., Rochmah, N. N., Issusilaningtyas, E., & Fadli. (2024). Behavior Analysis of Using Sunscreen to Protect Skin from The Sun. Jurnal Penelitian Pendidikan IPA, 10(SpecialIssue), 303–309. https://doi.org/10.29303/jppipa.v10ispecialissue.8050 DOI: https://doi.org/10.29303/jppipa.v10iSpecialIssue.8050
Wojtowicz, I., & Żychowska, M. (2025). Dermoscopy of Basal Cell Carcinoma Part 3: Differential Diagnosis, Treatment Monitoring and Novel Technologies. In Cancers (Vol. 17, Issue 6, p. 1025). https://doi.org/10.3390/cancers17061025 DOI: https://doi.org/10.3390/cancers17061025
Wunderlich, K., Suppa, M., Gandini, S., Lipski, J., White, J. M., & Del Marmol, V. (2024). Risk Factors and Innovations in Risk Assessment for Melanoma, Basal Cell Carcinoma, and Squamous Cell Carcinoma. In Cancers, 16(5), 1016). https://doi.org/10.3390/cancers16051016 DOI: https://doi.org/10.3390/cancers16051016
License
Copyright (c) 2025 Fanny Fauziyyah Heryadi, Nugrohoaji Dharmawan, Prasetyadi Mawardi , Endra Yustin Ellistasari , Suci Widhiati
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with Jurnal Penelitian Pendidikan IPA, agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution 4.0 International License (CC-BY License). This license allows authors to use all articles, data sets, graphics, and appendices in data mining applications, search engines, web sites, blogs, and other platforms by providing an appropriate reference. The journal allows the author(s) to hold the copyright without restrictions and will retain publishing rights without restrictions.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in Jurnal Penelitian Pendidikan IPA.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).
