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Clinical Problem Solving: Pathology
January 18, 2010

Pathology Quiz Case 1: Diagnosis

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Arch Otolaryngol Head Neck Surg. 2010;136(1):102-103. doi:10.1001/archoto.2009.180-b

BCAC is a rare salivary gland cancer that was largely undefined until the early 1990s, when it was first incorporated into the World Health Organization's Histological Typing of Salivary Gland Tumors.1Before acquiring a unique identity, BCAC had been reported under several names, including basaloid salivary carcinoma, carcinoma ex monomorphic adenoma, malignant basal cell adenoma, and malignant basal cell tumor.2BCAC is a low-grade malignant neoplasm and the malignant counterpart of basal cell adenoma. It presents at a mean age of 60 years and exhibits no sex predilection.2-4Incidence estimates range from 0.6% of major salivary gland tumors to 1.6% of all salivary neoplasms.2,3Most cases arise de novo, with only 23% representing malignant transformation of a basal cell adenoma.4,5Nine out of 10 BCACs involve the parotid gland, but rare examples have been identified in the submandibular gland, sublingual gland, buccal mucosa, lip, tongue, nasal cavity, sinuses, and lacrimal gland.4,6-8

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