Basaloid Squamous Cell Carcinoma of the Leg – A Rare Tumour at an Atypical Site

The most cutaneous malignancies with basaloid features are basal cell carcinoma variants. Basaloid squamous cell carcinoma (BSCC) is an uncommon entity with aggressive clinical behavior and distinct histopathological features. It is typically associated with human papillomavirus and has a strong predilection for the oropharyngeal and genital mucosa. Most reported cases of cutaneous BSCC are either metastatic in origin or localized to the mucocutaneous anogenital region. There are only a few reports of nonmetastatic, primary skin-derived BSCC outside the anogenital region. Here, we describe a primary cutaneous BSCC arising from the leg in an elderly immunocompetent female. Immunohistochemical staining was helpful to confirm the diagnosis and exclude the close mimickers. As the tumor was localized and the patient was elderly, palliative surgery was done. The differentiation of malignancies with basaloid features is important due to the aggressive clinical behavior and poor prognosis of BSCC. This case highlights the occurrence of BSCC at an unusual site – the leg – in an immunocompetent elderly patient, underscoring the importance of accurate histopathological and immunohistochemical diagnosis given its prognostic significance.