CASE REPORT Superficial Spreading Basal Cell Carcinoma of the Face: A Surgical Challenge (original) (raw)
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BASAL CELL CARCINOMA OF THE FACE: CLINICAL AND HISTOLOGICAL FEATURES, SURGICAL TREATMENT AND RESULTS
Background: Basal cell carcinoma (BCC) has a slow evolution and possible massive tissue destruction when neglected and reaches large dimensions. BCC involves various histological subtypes, the nodular form being the most common. Frequent localization on the face confirms that ultraviolet radiation is an important risk factor for this type of skin cancer. Basal cell carcinoma is most frequently on the cutaneous lips. It is reported that BCC is more frequent in the upper lip in women, while squamous cell carcinoma (SCC) seems to be more frequent in men, in the lower lip. Smoking and alcohol are reported as predisposing factors. The study purpose was to evidence the high incidence of BCC of the perioral and lips regions. 2) Methods: Retrospective descriptive study on a group of 55 patients diagnosed with BCCof the face, in whom surgical excision (in oncologic limits) treatment was performed, and postoperative follow-up was applied. 3) Results: The predominance of the ulcerated-infiltrative form was highlighted, predominantly in the age group between 60 and 80 years. 4) Conclusions: The increased number of BCC as well as the growing number of large and neglected tumors, evidenced the need of including BCC in a cancer registry and the implementation of a screening program, as well as a better information of the population regarding this type of skin cancer.
Basal Cell Carcinoma: 10 Years of Experience
Journal of Skin Cancer, 2011
Introduction. Basal cell carcinoma (BCC) is a locally invasive malignant epidermal tumour. Incidence is increasing by 10% per year; incidence of metastases is minimal, but relapses are frequent (40%-50%). The complete excision of the BCC allows reduction of relapse. Materials and Methods. The study cohort consists of 1123 patients underwent surgery for basal cell carcinoma between 1999 and 2009. Patient and tumor characteristics recorded are: age; gender; localization (head and neck, trunk, and upper and lower extremities), tumor size, excisional margins adopted, and relapses. Results. The study considered a group of 1123 patients affected by basal cell carcinoma. Relapses occurred in 30 cases (2,67%), 27 out of 30 relapses occurred in noble areas, where peripheral margin was <3 mm. Incompletely excised basal cell carcinoma occurred in 21 patients (1,87%) and were treated with an additional excision. Discussion. Although guidelines indicate 3 mm peripheral margin of excision in BCC <2 cm, in our experience, a margin of less than 5 mm results in a high risk of incomplete excisions.
Management of Basal Cell Carcinomas: Clinical Experience
Turkish Archives of Otorhinolaryngology
Objective: Basal cell carcinomas (BCC) mostly originate from the head and neck region. Main goal in BCC treatment is to achieve both aesthetic and functional results while observing the principles of tumor surgery. We report our experience regarding the clinical, histopathological features and surgical treatment results of head and neck basal cell carcinomas in the light of the literature. Methods: Files of patients with head and neck BCCs treated surgically in two university hospitals were retrospectively analyzed. Sociodemographic variables, location and size of tumor, pathological subtype, recurrence ratio, complications and technique of reconstruction were evaluated. Results: We analyzed 119 tumoral lesions in 105 patients of whom 55 (52.4%) were male and 50 (47.6%) were female. Their mean age was 67.3±12 years. The nasal region was the most common location area (n=42, 35.3%). Mean tumor size was 12.6 mm and tumor size range was 2-85 mm. The most commonly used reconstruction techniques were flap surgery, followed by primary closure, and skin grafts. Conclusion: It is important to remove the tumor with a clear surgical margin at least 4 mm and evaluate the five surgical margins with frozen sections intraoperatively. Operations are often performed under local anesthesia and are well tolerated by patients. The most common flaps used in the reconstruction are not only easy to learn but also sufficient in most cases. Skin grafts are good choices in defects located in the cavum concha and the external meatus.
Treatment of multiple superficial basal cell carcinomas with topical imiquimod
OncoReview, 2015
Basal cell carcinoma is the most common malignancy of man. The use of the topical imiquimod 5% cream offers a noninvasive, nonsurgical, and an effective option for the treatment of primary types superficial basal cell carcinoma (sBCC). We present a case series of patients who used imiquimod 5% cream with good therapeutic effect. The medication had a good tolerability profile and there were no ocular adverse events. Imiquimod 5% cream could be considered the first choice treatment for BCCs in older patients who are poor candidates to surgery.
Clinical variants, stages, and management of basal cell carcinoma
Indian Dermatology Online Journal, 2013
Basal cell carcinoma (BCC) is the most common paraneoplastic disease among human neoplasms. The tumor affects mainly photoexposed areas, most often in the head and seldom appears on genitalia and perigenital region. BCC progresses slowly and metastases are found in less than 0.5% of the cases; however, a considerable local destruction and mutilation could be observed when treatment is neglected or inadequate. Different variants as nodular, cystic, micronodular, superficial, pigment BCC are described in literature and the differential diagnosis in some cases could be difficult. The staging of BCC is made according to Tumor, Node, Metastasis (TNM) classification and is essential for performing the adequate treatment. Numerous therapeutic methods established for treatment of BCC, having their advantages or disadvantages, do not absolutely dissolve the risk of relapses. The early diagnostics based on the good knowledge and timely organized and adequate treatment is a precondition for better prognosis. Despite the slow progress and numerous therapeutic methods, the basal cell carcinoma should not be underestimated.
We present 2 rare cases of metatypical basal cell carcinoma - two 72-year-old male patients with ulcerative lesions localized either to the left forehead or the back. The biopsy revealed a metatypical basal cell carcinoma. The treatment consisted of a wide local elliptical excision with good cosmetic results. There was no sign of recurrence or metastasis during a 12 months follow-up period.Basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) make up 95% of the most common types of cancer in the world - the non-melanoma skin cancer (NMSC). BCC is known for its potential to be locally invasive while SCC for its potential to metastasize in lymph nodes. The meta-typical basal cell carcinoma (MTBC) is a rare type of tumor which combines the clinical and histopathological features of both BCC and SCC with a 5% risk for the development of metastases. The gold standard for diagnosis lies in the histopathological verification of the lesional tissue. Clinical examinations alone are no...
Journal of Forensic Medicine, 2021
Basal cell carcinoma is most common type of non-melanotic skin cancer. Causative agents are UV and ionizing radiation and chemicals. Nodular, pigmented, superficial, cystic and infiltrative are major subtypes. It is mainly treated by excision surgery in the form of wide local excision and reconstruction is done by various flaps. In our study 10 patients were included and found that carcinoma is commoner in old age female patients and mainly near right canthus of eyeball; treated with surgery which is well tolerated by all the patients.
Basal Cell Carcinoma: A Single-Center Experience
ISRN Dermatology, 2012
Background. Basal cell carcinoma comprises the vast majority of skin cancers. It predominantly affects fair-skinned individuals, and its incidence is rising rapidly. Etiology may be multifactorial, but sun exposure appears to play a critical role. When detected early, the prognosis is excellent. Thus appropriate diagnosis, treatment, and surveillance are of utmost importance. Methods. From January 1994 to May 2012, 518 basal cell carcinomas were excised in our clinic. Data were collected retrospectively. Results. During 18-year period, 518 BCCs were excised from 486 patients. Most of the patients were males with a median age of 65.6 years. Most of the basal cell carcinomas were located in the head region. Nodular histological subtype dominated our series. Six percent of the excised lesions required reexcision because of involved margins. Our recurrence rate was 6.94% with the nose and the periauricular and periocular regions being the most common sites of occurrence. Conclusion. Alt...
The Journal of Dermatology, 2011
Basal cell carcinoma (BCC) is a common skin cancer that arises from the cells of the basal layer of the epithelium or from the external root sheath of the hair follicle. In the present report, 256 cases treated surgically between 1999 and 2008 in our department were retrospectively analyzed. The most frequent BCC locations included the face (77.8%), especially the nose (26.9%) and eyelids (21.5%). Incomplete excisions occurred in 21 cases. Two patients experienced local recurrence; one of these patients exhibited a bone metastasis while the other had a metastasis of the parotid gland without the local recurrence. The rate of local BCC recurrence was 0.78%, which is lower than that described in previous reports. We categorized BCC into four histological types: superficial, solid, adenoid and infiltrative. The solid type was the most frequent histological type (62.1%). For preventive recurrence, we treated BCC patients with two‐step surgery when the tumor was large or histologically i...
A Clinical Study of Basal Cell Carcinoma
Medical Archives
Introduction: Basal cell carcinoma (BCC) is a non-melanocytic skin malignancy arising from basal cells of epidermis or follicular structures. Etiology of BCC is a multifactorial combination of genotype, phenotype, and environmental factors. There are several clinical variants of BCC including nodular, cystic, superficial, morphoeic, keratotic, pigmented and micronodular. Aim: The aim of our study was to analyze the recent clinical trends of basal cell carcinoma by reviewing a single institution's experience. Methods: Total number of 422 patients clinically diagnosed with basal cell carcinoma were included in the study. Data on age, gender, skin type, personal and family history, duration of disease, localization of lesions, clinical type of lesions, and recurrence rate were collected and analyzed. The data were statistically evaluated. Results: More than 80% of all BCC's were located on sun-exposed skin areas (p<0.05).The male /female ratio was 1:0.92. The nodular BCC was the most frequent type (59.2%), followed by the superficial (16.1%), pigmented (15.2%) and morphoeic (9.5%) types. The nodular and pigmented types were predominant located on the head and neck, whereas the trunk was the most common location for the superficial type (p<0.05). The tumor is commonly found in concomitance with skin lesion related to chronic sun exposure, such as actinic keratoses, solar lentigines and facial telangiectasia. During this study period, 41 cases showed recurrence of the cancer as the overall recurrence rate was 9.7%. There were no cases with metastasis or fatal outcome. Conclusions: The factors related to the development of BCC were older age and exposure to ultraviolet rays both in recreational and in occupational form. The prevention of BCC is based on the knowledge of risk factors, early diagnosis and treatment, particularly in susceptible populations.