Branchiogenic Basaloid Squamous Cell Carcinoma with Adenosquamous Features. Branchiogenic Carcinoma in the Setting of Another Head and Neck Primary: Literature Review and Report of a Case

The diagnosis of branchiogenic carcinoma is one of significant controversies in the field of head and neck oncology. Those who support its existence adhere to rigid criteria to validate its existence. Those that deny it, purport that the entity is simply metastatic disease masquerading as a branchial cleft primary. One aspect of agreement between the two opposing views is that a separate head and neck primary disqualifies the diagnosis of branchiogenic carcinoma. We report a case in which branchiogenic carcinoma was diagnosed in the presence of an additional base of tongue primary squamous cell carcinoma based on morphologic dissimilarity and evidence of origination from the basal layer of the branchial cleft epithelium. In doing so, we attempt to make the case that unequivocal histologic evidence of branchial cleft origin is the defining feature of branchiogenic carcinoma and, as with many other carcinomas, should be the diagnostic criterion of choice in issuing the diagnosis. A brief pertinent literature review is presented.