Basal Cell Nevus Syndrome and Sporadic Basal Cell Carcinoma: A Comparative Study of Clinicopathological Features

Authors

  • Ching-Ya Wang Department of Dermatology, Taipei City Hospital, Taipei, Taiwan
  • Chun-Bing Chen Department of dermatology, Chang Gung Memorial Hospital, Taipei, Linkou and Keelung, Taiwan; Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan; School of Medicine, National Tsing Hua University, Hsinchu, Taiwan
  • Franchesca Marie D. Ilagan Department of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
  • Jing-Yi Lin Department of dermatology, Chang Gung Memorial Hospital, Taipei, Linkou and Keelung, Taiwan; Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
  • Wen-Yi Sung Department of Dermatology, Kaohsiung Veterans General Hospital, Kaohsiung City, Taiwan.
  • Lai-Ying Lu Department of dermatology, Chang Gung Memorial Hospital, Taipei, Linkou and Keelung, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Dermatology and Aesthetic Medicine Center, Jen-Ai Hospital, Taichung, Taiwan
  • Jau-Yu Liau Department of Pathology, National Taiwan University Hospital, Taipei, Taiwan; Graduate Institute of Pathology, College of Medicine, National Taiwan University, Taipei, Taiwan
  • Yu-Hsiu Chen Department of Pathology, Chang Gung Memorial Hospital Linkou-Branch, Taoyuan, Taiwan
  • Yi-Hua Liao Department of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
  • Jau-Shiuh Chen Department of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
  • Yi-Shuan Sheen Department of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
  • Yao-Yu Chang Department of dermatology, Chang Gung Memorial Hospital, Taipei, Linkou and Keelung, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
  • Jin-Bon Hong Department of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.

DOI:

https://doi.org/10.2340/actadv.v105.40692

Keywords:

Basal cell carcinoma, Basal cell nevus syndrome, Gorlin syndrome, Odontogenic keratocyst, Pitting, PTCH1

Abstract

Basal cell nevus syndrome is caused by mutations in the Sonic hedgehog pathway and characterized by early-onset basal cell carcinoma. The features of basal cell carcinoma in basal cell nevus syndrome compared with sporadic basal cell carcinoma have not been explored. This study is a retrospective study of patients with basal cell nevus syndrome in two medical centres in Taiwan from 1991 to 2021 and patients with sporadic basal cell carcinoma excised from 2015 to 2020. An analysis of 18 patients with basal cell nevus syndrome showed an older mean age at the first diagnosis of basal cell carcinoma (37.5 years) than reported in Western countries. The majority of basal cell carcinomas were located in the head and neck region (80.7%), with nodular BCC being the most common tumour type (47.0%). Compared with sporadic basal cell carcinomas, basal cell carcinomas in basal cell nevus syndrome patients occurred more frequently on the scalp (34.7% vs 6.1%, p < 0.001). In addition, the superficial type of basal cell carcinoma was more likely to be seen in basal cell nevus syndrome (24.7% vs 10.4%, p < 0.001). The limitations were that some features of the basal cell nevus syndrome patients might not have been present yet at the time of examination or they did not receive thorough screening. In conclusion, the distinct features of basal cell carcinomas in basal cell nevus syndrome patients have important implications for the prevention, diagnosis, and management of basal cell carcinoma in basal cell nevus syndrome patients.

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References

Gorlin RJ, Goltz RW. Multiple nevoid basal-cell epithelioma, jaw cysts and bifid rib: a syndrome. N Engl J Med 1960; 262: 908–912.

https://doi.org/10.1056/NEJM196005052621803 DOI: https://doi.org/10.1056/NEJM196005052621803

Lo Muzio L. Nevoid basal cell carcinoma syndrome (Gorlin syndrome). Orphanet J Rare Dis2008; 3: 32.

https://doi.org/10.1186/1750-1172-3-32 DOI: https://doi.org/10.1186/1750-1172-3-32

Bree AF, Shah MR. Consensus statement from the first international colloquium on basal cell nevus syndrome (BCNS). Am J Med Genet Part A 2011; 155a: 2091–2097.

https://doi.org/10.1002/ajmg.a.34128 DOI: https://doi.org/10.1002/ajmg.a.34128

Evans DG, Ladusans EJ, Rimmer S, Burnell LD, Thakker N, Farndon PA. Complications of the naevoid basal cell carcinoma syndrome: results of a population based study. J Med Genet 1993; 30: 460–464.

https://doi.org/10.1136/jmg.30.6.460 DOI: https://doi.org/10.1136/jmg.30.6.460

Shanley S, Ratcliffe J, Hockey A, Haan E, Oley C, Ravine D, et al. Nevoid basal cell carcinoma syndrome: review of 118 affected individuals. Am J Med Genet 1994; 50: 282–290.

https://doi.org/10.1002/ajmg.1320500312 DOI: https://doi.org/10.1002/ajmg.1320500312

Kimonis VE, Goldstein AM, Pastakia B, Yang ML, Kase R, DiGiovanna JJ, et al. Clinical manifestations in 105 persons with nevoid basal cell carcinoma syndrome. Am J Med Genet 1997; 69: 299–308. DOI: https://doi.org/10.1002/(SICI)1096-8628(19970331)69:3<299::AID-AJMG16>3.3.CO;2-#

https://doi.org/10.1002/(SICI)1096-8628(19970331)69:3<299::AID-AJMG16>3.0.CO;2-M DOI: https://doi.org/10.1002/(SICI)1096-8628(19970331)69:3<299::AID-AJMG16>3.0.CO;2-M

Ahn SG, Lim YS, Kim DK, Kim SG, Lee SH, Yoon JH. Nevoid basal cell carcinoma syndrome: a retrospective analysis of 33 affected Korean individuals. Int J Oral Maxillofac Surg 2004; 33: 458–462.

https://doi.org/10.1016/j.ijom.2003.11.001 DOI: https://doi.org/10.1016/j.ijom.2003.11.001

Endo M, Fujii K, Sugita K, Saito K, Kohno Y, Miyashita T. Nationwide survey of nevoid basal cell carcinoma syndrome in Japan revealing the low frequency of basal cell carcinoma. Am J Med Genet Part A 2012; 158a: 351–357.

https://doi.org/10.1002/ajmg.a.34421 DOI: https://doi.org/10.1002/ajmg.a.34421

Göppner D, Leverkus M. Basal cell carcinoma: from the molecular understanding of the pathogenesis to targeted therapy of progressive disease. J Skin Cancer 2011; 2011: 650258.

https://doi.org/10.1155/2011/650258 DOI: https://doi.org/10.1155/2011/650258

Onodera S, Nakamura Y, Azuma T. Gorlin syndrome: recent advances in genetic testing and molecular and cellular biological research. Int J Mol Sci 2020; 21.

https://doi.org/10.3390/ijms21207559 DOI: https://doi.org/10.3390/ijms21207559

Jones EA, Sajid MI, Shenton A, Evans DG. Basal cell carcinomas in Gorlin syndrome: a review of 202 patients. J Skin Cancer 2011; 2011: 217378.

https://doi.org/10.1155/2011/217378 DOI: https://doi.org/10.1155/2011/217378

Verkouteren BJA, Cosgun B, Reinders M, Kessler P, Vermeulen RJ, Klaassens M, et al. A guideline for the clinical management of basal cell naevus syndrome (Gorlin-Goltz syndrome). Br J Dermatol 2022; 186: 215–226.

https://doi.org/10.1111/bjd.20700 DOI: https://doi.org/10.1111/bjd.20700

McKenna A, Hanna M, Banks E, Sivachenko A, Cibulskis K, Kernytsky A, et al. The Genome Analysis Toolkit: a MapReduce framework for analyzing next-generation DNA sequencing data. Genome Res 2010; 20: 1297–1303.

https://doi.org/10.1101/gr.107524.110 DOI: https://doi.org/10.1101/gr.107524.110

Wang K, Li M, Hakonarson H. ANNOVAR: functional annotation of genetic variants from high-throughput sequencing data. Nucleic Acids Res 2010; 38: e164.

https://doi.org/10.1093/nar/gkq603 DOI: https://doi.org/10.1093/nar/gkq603

Miller DT, Lee K, Chung WK, Gordon AS, Herman GE, Klein TE, et al. ACMG SF v3.0 list for reporting of secondary findings in clinical exome and genome sequencing: a policy statement of the American College of Medical Genetics and Genomics (ACMG). Genet Med 2021; 23: 1381–1390.

https://doi.org/10.1038/s41436-021-01172-3 DOI: https://doi.org/10.1038/s41436-021-01172-3

Hsu S-W, Lin C-Y, Wang C-W, Chung W-H, Yang C-H, Chang-Y. Novel patched 1 mutations in patients with Gorlin-Goltz syndrome strategic treated by smoothened inhibitor. Ann Dermatol 2018; 30: 597–601.

https://doi.org/10.5021/ad.2018.30.5.597 DOI: https://doi.org/10.5021/ad.2018.30.5.597

Rehefeldt-Erne S, Nägeli MC, Winterton N, Felderer L, Weibel L, Hafner J, et al. Nevoid basal cell carcinoma syndrome: report from the Zurich Nevoid Basal Cell Carcinoma Syndrome Cohort. Dermatology (Basel, Switzerland) 2016; 232: 285–292.

https://doi.org/10.1159/000444792 DOI: https://doi.org/10.1159/000444792

Moore MG, Bennett RG. Basal cell carcinoma in Asians: a retrospective analysis of ten patients. J Skin Cancer 2012; 2012: 741397.

https://doi.org/10.1155/2012/741397 DOI: https://doi.org/10.1155/2012/741397

Kimonis VE, Mehta SG, Digiovanna JJ, Bale SJ, Pastakia B. Radiological features in 82 patients with nevoid basal cell carcinoma (NBCC or Gorlin) syndrome. Genet Med 2004; 6: 495–502.

https://doi.org/10.1097/01.GIM.0000145045.17711.1C DOI: https://doi.org/10.1097/01.GIM.0000145045.17711.1C

Amlashi SF, Riffaud L, Brassier G, Morandi X. Nevoid basal cell carcinoma syndrome: relation with desmoplastic medulloblastoma in infancy. A population-based study and review of the literature. Cancer 2003; 98: 618–624.

https://doi.org/10.1002/cncr.11537 DOI: https://doi.org/10.1002/cncr.11537

Evans DG, Oudit D, Smith MJ, Rutkowski D, Allan E, Newman WG, et al. First evidence of genotype-phenotype correlations in Gorlin syndrome. J Med Genet 2017; 54: 530–536.

https://doi.org/10.1136/jmedgenet-2017-104669 DOI: https://doi.org/10.1136/jmedgenet-2017-104669

Ikehata H, Ono T. The mechanisms of UV mutagenesis. Journal of radiation research 2011; 52: 115-125.

https://doi.org/10.1269/jrr.10175 DOI: https://doi.org/10.1269/jrr.10175

Gorlin RJ. Nevoid basal cell carcinoma (Gorlin) syndrome. Genet Med 2004; 6: 530-539.

https://doi.org/10.1097/01.GIM.0000144188.15902.C4 DOI: https://doi.org/10.1097/01.GIM.0000144188.15902.C4

Verkouteren JAC, Pardo LM, Uitterlinden AG, Nijsten T. Non-genetic and genetic predictors of a superficial first basal cell carcinoma. J Eur Acad Dermatol Venereol 2019; 33: 533–540.

https://doi.org/10.1111/jdv.15389 DOI: https://doi.org/10.1111/jdv.15389

Thorsness SL, Freites-Martinez A, Marchetti MA, Navarrete-Dechent C, Lacouture ME, Tonorezos ES. Nonmelanoma Skin cancer in childhood and young adult cancer survivors previously treated with radiotherapy. JNCCN 2019; 17: 237–243.

https://doi.org/10.6004/jnccn.2018.7096 DOI: https://doi.org/10.6004/jnccn.2018.7096

Nishigori C, Arima Y, Matsumura Y, Matsui M, Miyachi Y. Impaired removal of 8-hydroxydeoxyguanosine induced by UVB radiation in naevoid basal cell carcinoma syndrome cells. Br J Dermatol 2005; 153 Suppl 2: 52–56.

https://doi.org/10.1111/j.1365-2133.2005.06970.x DOI: https://doi.org/10.1111/j.1365-2133.2005.06970.x

Applegate LA, Goldberg LH, Ley RD, Ananthaswamy HN. Hypersensitivity of skin fibroblasts from basal cell nevus syndrome patients to killing by ultraviolet B but not by ultraviolet C radiation. Cancer Res 1990; 50: 637–641.

Kim B, Kim MJ, Hur K, Jo SJ, Ko JM, Park SS, et al. Clinical

and genetic profiling of nevoid basal cell carcinoma syndrome in Korean patients by whole-exome sequencing. Sci Rep 2021; 11: 1163.

https://doi.org/10.1038/s41598-020-80867-0 DOI: https://doi.org/10.1038/s41598-020-80867-0

Smith MJ, Beetz C, Williams SG, Bhaskar SS, O’Sullivan J, Anderson B, et al. Germline mutations in SUFU cause Gorlin syndrome-associated childhood medulloblastoma and redefine the risk associated with PTCH1 mutations. J Clin Oncol 2014; 32: 4155–4161.

https://doi.org/10.1200/JCO.2014.58.2569 DOI: https://doi.org/10.1200/JCO.2014.58.2569

Kato C, Fujii K, Arai Y, Hatsuse H, Nagao K, Takayama Y, et al. Nevoid basal cell carcinoma syndrome caused by splicing mutations in the PTCH1 gene. Fam Cancer 2017; 16: 131–138.

https://doi.org/10.1007/s10689-016-9924-2 DOI: https://doi.org/10.1007/s10689-016-9924-2

Matsudate Y, Naruto T, Hayashi Y, Minami M, Tohyama M, Yokota K, et al. Targeted exome sequencing and chromosomal microarray for the molecular diagnosis of nevoid basal cell carcinoma syndrome. J Dermatol Sci 2017; 86: 206–211.

https://doi.org/10.1016/j.jdermsci.2017.02.282 DOI: https://doi.org/10.1016/j.jdermsci.2017.02.282

Morita K, Naruto T, Tanimoto K, Yasukawa C, Oikawa Y, Masuda K, et al. Simultaneous detection of both single nucleotide variations and copy number alterations by next-generation sequencing in Gorlin syndrome. PloS One 2015; 10: e0140480.

https://doi.org/10.1371/journal.pone.0140480 DOI: https://doi.org/10.1371/journal.pone.0140480

Additional Files

Published

2025-03-19

How to Cite

Wang, C.-Y., Chen, C.-B., Ilagan, F. M. D., Lin, J.-Y., Sung, W.-Y., Lu, L.-Y., … Hong, J.-B. (2025). Basal Cell Nevus Syndrome and Sporadic Basal Cell Carcinoma: A Comparative Study of Clinicopathological Features. Acta Dermato-Venereologica, 105, adv40692. https://doi.org/10.2340/actadv.v105.40692