Basal Cell Carcinoma of the Head and Neck

Abstract

Basal cell carcinoma (BCC) is a malignant neoplasm derived from nonkeratinizing cells that originate from the basal layer of the epidermis and is the most frequent type of skin cancer in humans, with cumulative exposure to ultraviolet radiation as an important risk factor. BCC occurs most frequently at sun-exposed sites, with the head and neck being common areas. Tumors can be classified as nodular, superficial, morpheaform, infiltrating, metatypic, and fibroepithelioma of Pinkus. Several treatment options such as surgical excision and nonsurgical procedures are available. The choice of treatment should be determined based on the histological subtype of a lesion, cost, its size and location, patient age, medical condition of the patient, treatment availability, and the patient's wishes. The aim of any therapy selected for BCC treatment involving the head and neck is to ensure complete removal, the preservation of function, and a good cosmetic outcome.

Correlation of dermoscopic findings with histopathologic variants of basal cell carcinoma

“…In the absence of histopathologic data, the presence of these dermoscopic findings would alert the clinician to suspect a BCC variant with high risk for local recurrence and thus to better plan the therapeutic approach. According to the literature, the suggested treatment for BCC of the high risk for local recurrence variant is Mohs micrographic surgery, whereas BCC of the low risk for local recurrence variant can be treated with conventional surgery, cryosurgery, electrosurgery, and other modalities …”

Basal Cell Carcinoma of the Head and Neck Region: An Analysis of 171 Cases

“…Other predisposing factors include exposure to radiotherapy, arsenic, albinism, burns, scars, immunosuppression, Bazex, and Gorlin syndromes [7–10]. …”

“…There are distinct islands and cords of cells with palisading or “picket fence” arrangement of the peripheral cells that mimics the basal layer of the skin. Some lesions produce keratin with pearl formation and in others benign melanocytes give the lesion a black color [7, 13]. …”

Basal cell carcinoma on the ear is more likely to be of an aggressive phenotype in both men and women

“…24 Treatment and cure of BCC can readily be accomplished with multiple modalities, 18 however, the choice of treatment is most often based on factors such as whether the tumor is recurrent or primary, 9 anatomic location, 25 and histologic subtype. 14,17,19,26,27 …”