Pulmonary Metastasis of Basal Cell Carcinoma of the Skin (original) (raw)

Basal cell carcinoma with lung metastasis

The Japanese Journal of Surgery, 1985

A forty-seven year-old man had a small ulceration on his left cheek. The ulcer had a repeated crust formation following removal, for ten years. The patient found a hard tumor in the deep site of the ulcer and the tumor was resected. The pathological diagnosis was basal cell carcinoma. The metastases to the regional lymph nodes developed one year later and these lymph nodes were resected. The histological picture was the same as seen in the primary tumor. Lung metastasis occurred three years later. The tumor was resected and the pathological diagnosis was basal cell carcinoma. Multiple lung metastases developed one year later and massive hemoptysis led to a sudden death two years after the thoracotomy. Thirty-seven cases of basal cell carcinoma with lung metastases were reported in the literature. This case is the thirty-eighth case and the third occurrence in a Japanese.

An aggressive Basal Cell Carcinoma with multiple focuses and distant lung metastasis: case report

Cumhuriyet Medical Journal, 2012

Basal cell carcinoma (BCC) is a malignant neoplasm derived from nonkeratinizing cells that originate from the basal layer of the epidermis and it is the most common type of skin cancer in humans. Giant BCC (i.e. greater than 5 cm in diameter) is quite rare and comprises 0.5 percent of all BCC. Despite the high incidence of BCC, metastasis of this tumor is rare, with rates ranging from 0.0028% to 0.55% of all BCC cases. In this case, the tumour reached a giant size and had a pulmonary metastasis.,We aimed to emphasize that although BCC's are usually indolent; the importance of adequate surgery and chemoradiotherapy should always be considered in indicated cases.

Metastasizing basal cell carcinoma

Basal cell carcinoma (BCC) is the most common malignancy worldwide and is characterized by invasive growth and local tissue destruction. Cure rates for BCC exceed 90% with most treatment modalities. Metastasizing BCC (MBCC) is a rare complication of BCC with high morbidity and mortality rates. We report the case of a 66-year-old man with a large ulcerative lesion on the left side of the flank that was histopathologically diagnosed as a BCC. Clinical and imaging evaluations revealed substantial local invasion with regional lymph node, lung, liver, bone marrow, and bone metastasis. The patient died 7 months after the diagnosis was made. Potentially metastasizing BCCs cannot be definitely identified; thus early intervention with adequate treatment of all BCCs is advised.

Lung metastasis of basal cell carcinoma on anterior chest wall: A rare case report

GSC Advanced Research and Reviews, 2020

Introduction: Metastasis of primary basal cell carcinoma (BCC) on thoracic wall is rarely reported in literatures. Metastasis of cancer to the lung is suggested of hematogenous spread to the lung. We reported the only case of metastatic BCC encountered in Dr. Moewardi Hospital Surakarta. Case: A 62-year-old female patient was referred to our hospital with a recurrent lump on the anterior part of her chest accompanied by radiating pain to the back lasting for about a year. Previously she had undergone surgery, but the lump regrew on the similar location. Histopathology finding revealed infiltrating BCC. Chest radiograph showed miliary type pulmonal metastasis. Contrast CT-Scan imaging revealed a malignant solid mass on the anterior thoracic wall with lung metastasis, manifesting as pneumonia and left pleural effusion, in accordance to pneumonic and subpleural type pulmonal metastasis. Subsequently, patient underwent chemoradiotherapy, resulting in positive response of tumor regressio...

Metastatic Basal Cell Carcinoma: A Biological Continuum of Basal Cell Carcinoma?

Case Reports in Dermatological Medicine, 2012

Basal cell carcinoma (BCC) accounts for 80% of all nonmelanoma skin cancers. Its metastasis is extremely rare, ranging between 0.0028 and 0.55 of all BCC cases. The usual metastasis to lymph nodes, lungs, bones, or skin is from the primary tumor situated in the head and neck region in nearly 85% cases. A 69-year-old male developed progressively increasing multiple, fleshy, indurated, and at places pigmented noduloulcerative plaques over back, chest, and left axillary area 4 years after wide surgical excision of a pathologically diagnosed basal cell carcinoma. The recurrence was diagnosed as infiltrative BCC and found metastasizing to skin, soft tissue and muscles, and pretracheal and axillary lymph nodes. Three cycles of chemotherapy comprising intravenous cisplatin (50 mg) and 5-florouracil (5-FU, 750 mg) on 2 consecutive days and repeated at every 21 days were effective. As it remains unclear whether metastatic BCC is itself a separate subset of basal cell carcinoma, we feel that early BCC localized at any site perhaps constitutes a biological continuum that may ultimately manifest with metastasis in some individuals and should be evaluated as such. Long-standing BCC is itself potentially at risk of recurrence/dissemination; it is imperative to diagnose and appropriately treat all BCC lesions at the earliest.

Metastatic basal cell carcinoma: Report of twelve cases with a review of the literature

Journal of the American Academy of Dermatology, 1991

Metastatic basal cell carcinoma was found in 12 patients at the University of Wisconsin Mohs Surgery Clinic during the period 1936 to 1989. All patients were white men. The time of onset of the primary tumor ranged from childhood to 71 years. Eleven patients had previous treatment for basal cell carcinoma; two patients had received x-ray radiation to the face for teenage acne. The locations of the primary basal cell carcinomas were the face (n = 10), back (n = 1), and arm (n = 1). The primary tumors ranged from 3.6 X 3.0 to 20.0 X 7.0 em. The interval from onset to the first sign of metastases ranged from 7 to 34 years. In all cases, the primary tumor was histologically identical to the metastatic lesion. Perineural extension of the basal cell carcinoma in the primary lesion was found in five cases. Regional lymph nodes were the most frequent site of metastasis. Treatment consisted of a combination of surgery, radiation, and chemotherapy. Only two patients survived more than 5 years after surgical treatment. One patient has survived 25 years and is still alive. (J AM ACAD DERMATOL

Simultaneous two organ metastases of the giant basal cell carcinoma of the skin

International Seminars in Surgical …, 2005

Background: Basal Cell Carcinoma (BCC) is the most common carcinoma in humans. It accounts for 20% of carcinomas in men and 10-15% of carcinomas in women. Despite its high incidence, metastatic events are exceedingly rare. The reported frequency of metastatic dissemination is estimated at 0.0028-0.5 percent. Once metastasis is detected, there is a high mortality rate of 50% within 8 months. Methods: In this study, we present a case of simultaneous lung and parotid metastases of giant BCC primary located on the right medial canthus of a 62 year old female. Results: Examination of the tumor located on the medial canthus obtained showed "adenoid BCC". Computed tomography (CT) was performed to evaluate parotid region for evaluation of parotid gland and chest. Parotid and lung metastasis were detected in CT. Routine labarotory tests and radiological investigations were done. There was no abnormal finding. We also investigated this patient with a bone scan (normal), abdominal and cranial CT scans (also normal). Conclusion: Although metastasis of BCC is a very rare condition, this study reports a case of simultaneous parotid gland and lung metastasis originating from a giant BCC primary that was located on the right inner canthus of a 62 year old female.

Metastatic basal cell carcinoma: Review, report of a case, and chemotherapy

Cancer, 1974

Basal cell carcinomas very rarely metastasize. A review of the literature revealed 90 documented cases of metastasizing basal cell carcinoma. Metastases occur most frequently to the regional lymph nodes (68%), while other sites such as bone, lungs, and liver are less frequently involved (less than 20%). W e wish to report a case of metastasizing basal cell carcinoma and our experience with chemotherapy. Chemotherapy has been utilized in only three of the previously reported cases. To date a total of seven different cytotoxic agents has been tried; all have been unsuccessful. At present the drug of choice for metastasizing basal cell carcinoma awaits reports of successful treatment of metastasizing lesions; nevertheless, since the appearance of metastases in basal cell carcinoma carries a n ominous prognosis (median survival of only 10 months), chemotherapy should be offered to these patients.

Metastatic basal cell carcinoma of the head and neck

The Laryngoscope, 1995

Metastases are occasionally associated with cutaneous squamous cell carcinoma but only rarely with basal cell carcinoma. There are approximately 200 cases of metastases from basal cell carcinoma reported in the world literature. We describe 6 additional cases. All of our patients demonstrated recurrence at the primary site before they developed their metastases. Metastases presented in subcutaneous tissue, cervical lymph nodes, bone, and lung between 1.5 and 14 years after initial treatment of the primary lesion. The long interval seen in these patients between the initial treatment of the primary and the development of metastases underscores the need for long‐term follow‐up in what is often thought to be a nonaggressive, nonmetastasizing malignancy.

Metastatic Basal Cell Carcinoma: A Case Report

Journal of Medical Cases, 2012

An 86 year old lady presented to her GP with a 2 month history of right hip and left thigh pain. Pelvic plain x-rays revealed a lytic lesion in the left femur and right acetabulum. Thorough clinical examination found an 80 x 60 mm exophytic tumor with an ulcerated surface on her left shoulder. This had been present for over 4 years, the patient believing it 'just a patch of eczema'. A subsequent CT chest, abdomen and pelvis revealed further bony lesions in her sternum, first rib and sacrum. A biopsy of the left shoulder lesion confirmed ulcerated basal cell carcinama (BCC). Hisological and immunohistochemical examination of a biopsy from the bony lesion in the sternum and first rib confirmed a diagnosis of metastaic BCC. Our patient commenced on treatment with imiquimod cream to the primary BCC, had a rod inserted into her left femur in order to prevent a pathological fracture and was offered palliative radiotherapy for the metastatic deposits, which she declined. She died six weeks later. Worldwide BCC incidence is increasing, but has very high cure rates with early complete surgical excision. Metastatic BCC is very rare but incidence is higher with larger tumors, because large vessel blood supply may facilitate haematological seeding of the tumor. Once it metastasises, BCC is highly malignant with short survival times, usually measurable in months. Our patient is likely to have had metastatic disease for some months prior to presentation.

Metatypical basal cell carcinoma: a clinical review

Journal of Experimental & Clinical Cancer Research, 2008

Background: Metatypical cell carcinoma can be considered as a new entity of skin cancer, being an intermediate typology between basal cell carcinomas and squamous cell carcinomas. The behaviour of the metatypical cell carcinoma lies between these two varieties of skin cancer. It is difficult to perform a differential diagnosis based on morphological and clinical features -therefore it is only possible by accurate histology.

Metatypical basal cell carcinoma: a clinical review.(Review)(Clinical report)

Journal of Experimental Clinical Cancer Research, 2008

A Rare Report of Lung Metastasis of the Common Non-Melanotic Skin Cancer

Tanaffos, 2018

Basal cell carcinoma is a common non-melanotic skin cancer with a prevalence of 74.5%–82.6% in the Iranian population. BCC rarely metastasizes. However, metastasis can cause significant morbidity. The prevalence of metastatic basal cell carcinoma varies between 0.0028% and 0.55% of all cases. We describe a case of lung metastasis of basal cell carcinoma of the scalp.

Pulmonary metastases: A rare manifestation of the most common cancer

Australasian Journal of Dermatology, 2013

Basal cell carcinoma (BCC) is the most common human malignancy but rarely metastasises. We report on two patients with symptomatic lung metastases and a past history of recurrent BCC excisions. In our first patient, a heavy smoker with multiple lung lesions, histology of a resected nodule was first reported as non-small cell lung cancer but a repeat nodule biopsy a year later was recognised as a pulmonary metastasis from primary cutaneous BCC. Our second patient, a young never-smoker with two previous BCC, was confirmed as having a pulmonary metastasis from BCC on the lung resection specimen. Pulmonary metastasis from an unidentified primary site is a common clinical situation. These patients emphasise the importance of considering the most common cancer as a potential primary.

Multiple non-syndromic basal cell carcinoma with the chest as primary site and lung metastases: A rare case

Dermatology Reports, 2021

Basal cell carcinoma (BCC) is the most commonly diagnosed cancer in humans, usually affecting elderly Caucasian men and skin regions mostly exposed to the sun, that rarely metastasizes. We report an unusual and aggressive case of multiple, non-syndromic metastatic BCC with an uncommon primary site in the chest and pulmonary metastases, treated successfully with surgery and vismodegib. A 51-year-old woman presented with a large pigmentary lesion of the chest, close to the sternum. She had the lesion for > 25 years and lately noticed multiple facial lesions. The diagnosis of multiple BCC was suspected and a punch biopsy of the primary lesion was performed. Diagnosis was confirmed by immunohistochemistry (BerEp4+, EMA− phenotype). After excision, staging with a thorax computed tomography scan revealed metastatic micro-nodules in the left lung, confirmed histologically after video-assisted thoracic surgical biopsy. Adjuvant chemotherapy with vismodegib was proposed and administered. At 30 days follow-up, thorax computed tomography scan was unaltered and her facial lesions showed significant regression. Although prognosis remains poor, early diagnosis and prompt management complimented by novel biological agents, like vismodegib, targeting disease pathogenesis, seems to bring promising results.

Metastatic basal cell carcinoma: Prognosis dependent on anatomic site and spread of disease

European Journal of Cancer, 2014

KEYWORDS Carcinoma, basal cell/ secondary Neoplasm metastasis Epidemiology Skin neoplasms/pathology Treatment outcome Abstract Purpose: This review provides a description of the epidemiology and survival outcomes for cases with metastatic basal cell carcinoma (mBCC) based on published reports . Methods: A literature search (MEDLINE via PubMed) was conducted for mBCC case reports published in English: 1981-2011. There were 172 cases that met the following criteria: primary BCC located on skin, metastasis confirmed by pathology and metastasis not resulting from direct tumour spread. From these, 100 mBCC cases with explicit information on follow-up time were selected for analysis. Survival analysis was conducted using Kaplan-Meier methods. Results: Among 100 mBCC cases selected for analysis, including one case with Gorlin syndrome, 50% had regional metastases (RM) and 50% had distant metastases (DM). Cases with DM were younger at mBCC diagnosis (mean age, 58.0 versus 66.3 years for RM; P = 0.0013). Among 93 (of 100) cases with treatment information for metastatic disease, more DM cases received chemotherapy (36.2% versus 6.5% for RM), but more RM cases underwent surgery (87.0% versus 40.4% for DM). Among all 100 cases, median survival after mBCC diagnosis 0959-8049/$ -see front matter Ó A v a i l a b l e a t w w w . s c i e n c e d i r e c t . c o m ScienceDirect j o u r n a l h o m e p a g e : ww w . e j c a n c e r . c o m was 54 months (95% confidence interval (CI), 24-72), with shorter survival in DM (24 months; 95% CI, 12-35) versus RM cases (87 months; 95% CI, 63-not evaluable). Conclusion: Cases with RM and DM mBCC may have different clinical courses and outcomes. Based on published reports, DM cases were younger at mBCC diagnosis, with shorter median survival than RM cases. This study provides a historical context for emerging mBCC treatments.

Markedly improved overall survival in 10 consecutive patients with metastatic basal cell carcinoma

British Journal of Dermatology, 2013

Background Metastatic basal cell carcinoma (BCC) is a rare but life-threatening condition. Prior estimates of overall survival (OS) from time of diagnosis of distant metastasis to death are approximately 8-14 months. However, these estimates are based on analyses of case reports published prior to 1984. Objectives To assess an updated OS in patients with metastatic BCC at a single academic institution. Methods Using patients seen from 1997 to 2011, a retrospective chart review was performed on biopsy-confirmed cases of distant metastatic BCC at Stanford University School of Medicine. Kaplan-Meier analysis was used to determine OS and progression-free survival (PFS). Results Ten consecutive cases of distant metastatic BCC were identified. Median OS was 7Á3 years [95% confidence interval (CI) 1Á6-∞]; median PFS was 3Á4 years (95% CI 1Á1-5Á2). Conclusions Our findings suggest that OS in patients with distant metastatic BCC may be more favourable than previously reported.

Metastatic Basal Cell Carcinoma: A Rare Manifestation of a Common Disease

Case Reports in Medicine, 2017

Introduction Basal cell carcinoma (BCC) is considered the most common malignancy in Caucasians. It constituted about 80% of all nonmelanoma skin tumors and, despite its high prevalence, is an extremely rare occurrence of metastases, with incidence rates varying from 0.0028% to 0.55%. Case Report A 58-year-old male patient with BCC on the left nasolabial sulcus for 17 years, reporting 3 previous excisions, evolved with local recurrence. A new procedure was performed, and anatomopathological study confirmed sclerosing BCC. Seven months later, he presented with a mass in the left submandibular region. Combined positron-emission tomography and computed tomography (PET-CT) showed cervical hypercaptation in the left cervical level I and vertebral body of L5. Excision of the cervical lesion was performed with diagnosis of sclerosing BCC compromising the submandibular gland. Biopsy of the lumbar lesion was found to be compatible with bone metastasis. Conclusion BCC represents a very common ...

Metastatic head and neck cutaneous basal cell carcinomas: a retrospective observational study

Archives of Dermatological Research, 2020

Cutaneous basal cell carcinoma is usually an indolent and slow-growing tumor with potential for local invasion and recurrence; however, metastatic events are exceedingly rare. The annual incidence of metastasis is estimated to range between 0.00281 and 0.05%. A retrospective search in the pathology database of a single tertiary institution was performed in the period between 1999 to 2019. Primary cutaneous metastatic basal cell carcinomas had paraffin blocks and glass slides retrieved. A total of 8673 cases was identified. The overall prevalence of metastatic tumors was 0.05% (4/8673). The median patient's age at diagnosis was 61 years old (range 52-79). The most common primary site of tumor was nose (2/4) and the most common histological subtype was infiltrative. The sampled lymph nodes were identified during primary tumor resection, except for 1 patient who had a sentinel lymph node biopsy performed as a surgeon individual decision. One patient had hematogenous spread to the pleura, diagnosed 5 years after diagnosis. In summary, this study adds new data to the current literature in metastatic primary cutaneous basal cell carcinomas and highlights the importance of early diagnosis and appropriate surgical excision in an effort to prevent local advanced disease, recurrence and lymphovascular dissemination.