TITLE:
Cholesterol Crystal Deposition in Basal Cell Carcinoma: An Investigation of 4 Cases
AUTHORS:
Ken Okamura, Takayuki Konno, Masakazu Kawaguchi, Yuko Abe, Yoriko Yaguchi, Sayaka Ajima, Yutaka Hozumi, Tamio Suzuki
KEYWORDS:
Apoptosis, Basal Cell Carcinoma, Cholesterol Cleft, Cholesterol Crystal
JOURNAL NAME:
Journal of Cosmetics, Dermatological Sciences and Applications,
Vol.5 No.3,
August
24,
2015
ABSTRACT: Cholesterol crystals are a primary cause of cholesterol embolism if they
appear in vessels. Various papers have reported the involvement of cholesterol
crystal deposition in cutaneous diseases such as xanthoma. However, no cases of
cholesterol crystal involvement in cutaneous cancer have been reported. We
report four cases of basal cell carcinoma with cholesterol crystal deposition,
and discuss the mechanism(s) of the condition. Disease duration, anatomical
site, histopathological features, and serum lipid profiles were investigated. The
median disease duration was 3.5 years, and the sites of the lesions were the
scrotum (one patient) and the nose (three patients). Histopathologically, there
was necrotized tissue around the clefts. In addition, we detected frequent
apoptotic cells around the cholesterol clefts in two of the patients by using
the terminal deoxynucleotidyl transferase dUTP nick-end labeling method. Serum
lipid levels were slightly elevated in two of the patients. In conclusion,
cholesterol crystal deposition in basal cell carcinoma was considered to relate
to a long disease duration with a tumor in a region that was subject to
external irritation. Histopathologically, apoptotic cells around the
cholesterol clefts indicated that lipids from the tumor cell membranes were one
of the causes of cholesterol crystal deposition.