To test the ability of BCC to grow in a mouse with complete and severe immuno-incompetence, 14 individual BCC were transplanted into the subcutaneous tissue of 18 SCID-beige mice (T, B and natural killer cell deficient). Light microscopy and immunophenotypic analyses were performed on primary BCC and first and seventh passage
tumors.
RESULTS:
Transplantation of three BCC yielded rapidly growing anaplastic
tumors for a
tumor take of 18% (3/18). SCID-beige mice without
tumor growth had mostly
scars or
epidermoid cysts at the transplant sites. The three patients whose BCC gave rise to the anaplastic
tumors were significantly older than those without
tumor growth (87 vs. 64, p = 0.001), but they did not differ with respect to BCC type or general health. These three anaplastic
tumors were histologically and immunophenotypically similar, being composed of dyscohesive, pleomorphic cells that expressed
vimentin and smooth muscle actin. In the first passage mice these
tumors were locally invasive,
tumor-forming nodules associated with an expansion of donor inflammatory cells (T and B lymphocytes and plasma cells), rare remnants of BCC epithelium and
epidermoid cysts. By the seventh passage, the
tumors were homogenous and metastasized widely throughout the mice. Changing
transplantation location to the dermis to
wound environment or supplementing the
tumor with BCC-derived fibroblasts did not alter the phenotype or growth rate in SCID-beige mice. Anaplastic
tumors also grew easily in SCID mice (T and B cell deficient). However,
transplantation of the anaplastic
tumors into normal mice (CB-17) or less severely immunodeficient mice (NCr and Balb/c: T and natural killer cell deficient) did not allow for growth. Furthermore,
tumor growth could not be maintained in vitro.
CONCLUSION: Empirically, these data suggest that BCC has the potential to become an aggressive metastatic
neoplasm, given the right immune and stromal environment. Moreover, a functional B lymphocyte system appears to prevent this growth. As human lymphocytes also engraft in SCID-beige mice, the original host immune response could be responsible for the lack of
tumor growth in the majority of xenografts. Furthermore, the anaplastic and metastatic phenotype of these BCC derived
neoplasms may be the experimental equivalent of metastatic BCC and BCC associated with
carcinosarcoma.