ENT Quiz – What’s the molecules telling?


A 65-year-old male presented with a nonhealing ulcer over the pinna of the right ear for 5 months. A biopsy from the lesion was done and the following is the report.

  • Carcinoma with basaloid features and pigmentation – biopsy right pinna.
  • Immunostaining: P63 – diffuse strong positivity. P40 – diffuse moderate positivity. BerEP4 – negative.


Based on the histopathology report, the most probable diagnosis is squamous cell carcinoma.

  • p40 & P63 are molecular markers sensitive and specific for SqCC.
  • BerEP4 is a monoclonal antibody that is used as a marker of BCC. It works by detecting the EpCAM antigen, a transmembrane epithelial glycoprotein cell adhesion molecule found in humans. BerEP4 is made from human mammary as well as mice carcinoma cell lining (MCF-7).


  1. Anthony Paulo Sunjaya, Angela Felicia Sunjaya, and Sukmawati Tansil Tan, “The Use of BEREP4 Immunohistochemistry Staining for Detection of Basal Cell Carcinoma,” Journal of Skin Cancer, vol. 2017, Article ID 2692604, 10 pages, 2017.
  2. https://www.pathologyoutlines.com/topic/stainsdeltaNp63.html


Dr. Sanu. P. Moideen, MBBS, MS (ENT), DNB (ENT), FHNOS, is an otolaryngologist (ENT surgeon), head and neck oncosurgeon practising in Muvattupuzha, Kerala, India. After finishing his postgraduate training, he pursued specialist training in paediatric ENT and head and neck oncosurgery from eminent institutions in India and the US.

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