Basosquamous carcinoma is a rare, aggressive non-
melanoma skin cancer with features that lie between those of
basal cell carcinoma and
squamous cell carcinoma. A lot of controversy has been raised around the classification, pathogenesis, histologic morphology,
biologic behavior, prognosis and management of this
tumor. This is a narrative review based on an electronic search of articles published in PubMed in English language which had in their title the terms "
basosquamous carcinoma" and/or "metatypical
carcinoma of the skin". The aim of this review was to summarize and evaluate current data regarding epidemiology, clinical presentation, dermoscopic and histopathologic characteristics, as well as the genetics and management of BSC, in order to shed some more light onto this intriguing entity. As a conclusion, dermoscopy, deep incisional biopsies and immunohistologic techniques (Ber-EP4) should be applied in clinically suspicious lesions in order to achieve an early diagnosis and better prognosis of this
tumor. Surgical treatments, including wide excision and
Mohs' micrographic surgery, remain the treatment of choice. Finally,
vismodegib, a Hedgehog pathway inhibitor, must be thoroughly investigated, with large controlled trials, since it may offer an alternative
solution to irresectable or difficult-to-treat, locally advanced cases of
basosquamous carcinoma.