Basal cell carcinomas and normal skin were examined in relation to the abnormal expression of gangliosides. The content of gangliosides with 9-O-acetylated sialic acids of 26 sample pairs was analyzed by a microtiter assay using influenza C virus as well as by fluorimetric high-performance liquid chromatography of the sialic acids released. The 9-O-acetylation levels were significantly (up to 56-fold) higher in basal cell carcinoma tissues than in the skin surrounding basal cell carcinomas. Slightly elevated amounts of O-acetylated gangliosides were also seen in the skin marginal to the basaliomas. The ganglioside composition of four sets of pooled samples of basal cell carcinoma and one pool of normal skin were studied by high-performance thin-layer chromatography and immune high-performance thin-layer chromatography using monoclonal antibodies against 9-O-acetyl GD3. The lipid-bound sialic acid content of normal skin was 0.029 microg dry weight, whereas in nodular basal cell carcinomas it was approximately twice as much. Several O-acetylated sialic acids were seen by high-performance liquid chromatography analysis, but N-acetyl-9-O-acetylneuraminic acid prevailed. Only in the tumor ganglioside fraction, a small amount of N-glycolylneuraminic acid was found. The 9-O-acetylated gangliosides with mainly 9-O-acetyl-GD3 can be considered as tumor-associated antigens or markers for basal cell carcinomas. This finding about tumor-associated carbohydrates may contribute to new strategies in current tumor diagnosis and therapy.