Age does not seem to be a discriminant or permissive factor for a particular histologic pattern of BCC. The prevalence of some subtypes for a particular body area may be explained on the basis of local predisposing conditions affecting the histologic development of the tumor.

Unusual location has been arbitrarily defined in the past according to the incidental percentage, to a mathematical index of density, to the literature reports. All these criteria suffer more or less from some discrepancy, but in our opinion all these should be considered for a definition. Our results, moreover, suggest that only the above described sites should be considered.

Four cases of giant basal cell carcinoma (BCC) are reported and the problems of giant BCCs are briefly discussed. In particular, we consider the relationship between the size of the tumor and its clinical behaviour. The importance of the site location in tumor development the histologic subtypes involved, the associated findings, and problems of treatment are also discussed.

Melanocytic nevi, both congenital and acquired, are considered to be precursors of melanomas. Data about the malignant potential of these nevi are conflicting, particularly with reference to the nevus of the smallest size. Patients with preexisting melanocytic nevi (both congenital and acquired) have risks of developing melanoma that differ from those of subjects without them. The purpose of this study was to verify the presence of melanoma in preexisting nevi both congenital (congenital nevus associated melanoma) (CNAM) and acquired (ANAM). In particular, we investigated melanomas associated with small congenital nevi (SCN). A cohort of 190 patients with primary melanomas was studied. Congenital nevi were called "small" (SCN) when their diameters were less than 1.5 cm. Epiluminescence microscopy (ELM) was performed to further improve the clinical diagnosis and to observe the more subtle changes in the preexisting nevi. Forty of the 190 cases of melanoma were associated with preexisting nevi; of these, 15 had congenital features with a CNAM largest diameter of 1.5 cm. These 15 cases were melanomas of the superficial type with a mean tumor thickness lower than that of ANAM (0.33 vs 1.50). There were no differences between the locations of CNAM and other melanomas. Male patients were significantly more affected. ELM microscopy permitted us to detect the early malignant changes in nevi and thus to improve our diagnosis. A high percentage of small congenital nevi were found to be associated with melanomas. They may be considered as melanomas precursors. Because of their large number and frequency, prophylactic removal of all SCN is not feasible. However, they should be removed as soon as possible when clinical or ELM changes are observed.