Basal Cell Carcinoma of the Head and Neck: Identification of the High Risk Patient

Levine, Howard L.; Bailin, Philip L.

doi:10.1002/lary.1980.90.6.955

Cited by 96 publications

(55 citation statements)

References 7 publications

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“…Overall, neoplastic margin involvement at histological examination was present in 17% (122 lesions) of excisions in our cases, with a 6.5-20.7% range as reported in the literature (23). The global recurrence rate assessed (14.7%) was within the 5-19% range reported in most previous studies (7)(8)(9)11,12,27). Regarding surgical excision, a 38.5% recurrence was noted when histological analysis showed an infiltration (lateral, deep or both margins infiltration), while a 25.5% recurrence rate for lesions with suboptimal excision can be expected and a 8.4% recurrence with histologically confirmed optimal excision, nevertheless, was recorded during the follow-up.…”

Section: Discussionsupporting

confidence: 72%

“…According to the literature, surgically excised primary BCCs may show a recurrence rate that varies from 5 to 14% (7)(8)(9)(10)(11)(12). The rates of recurrence appear to depend, to a large extent, on the anatomical localization, the histological characteristics, the initial treatment strategy and the eventual neoplastic margin involvement.…”

Section: Introductionmentioning

confidence: 99%

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Facial basal cell carcinoma: Analysis of recurrence and follow-up strategies

Sartore

Lancerotto²,

Salmaso³

et al. 2011

Oncol Rep

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Abstract. Rates of recurrence after incomplete surgical excision of basal cell carcinoma (BCC) range from 4 to 16.6% of analyzed cases. The aim of the present study was to identify the predictive factors associated with facial BBC recurrence following excision and their influences, in order to establish a proper therapeutic strategy. A monocentric retrospective study was performed reviewing all BCCs surgically excised at the Institute of Plastic Surgery, University of Padua, with particular focus on the involvement of surgical margins and recurrence. Seven hundred and nineteen lesions in 605 patients were studied. Correlations between recurrence probability and various characteristics of BCC were analyzed using a logistic regression model. It was observed that incomplete excision, deep margin involvement, the presence of sclerodermiform or metatypic basaloid squamous cells, as well as pleomorphous histological variants and/or peritumoral inflammatory infiltrates, were all related to an increase in the probability of recurrence. BCC excision must be followed by individualized management with particular consideration for the localization, the histological type and other known predisposing factors; the treatment strategy and, in particular, the length of the surveillance period and the frequency of patient assessment should be evaluated on the basis of the recurrence probability outlined.

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Section: Discussionsupporting

confidence: 72%

Section: Introductionmentioning

confidence: 99%

Facial basal cell carcinoma: Analysis of recurrence and follow-up strategies

Sartore

Lancerotto²,

Salmaso³

et al. 2011

Oncol Rep

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“…BCC is the most commonly occurring skin cancer in humans, and its incidence appears to be increasing (1,3). The vast majority of patients develop BCC on sun-exposed areas of the skin, in direct proportion to the number of pilosebaceous units present (4).…”

Section: Discussionmentioning

confidence: 99%

“…B asal cell carcinoma (BCC) is the most common cutaneous malignancy that humans acquire in the course of a lifetime (1). Approximately 85% of all BCCs appear in the head and neck region, with only 10% occurring in the torso and trunk (2,3). Basal cell lesions that occur in areas not exposed to the sun occasionally have a propensity for aggressive and locally invasive behavior.…”

Section: Rapport De Cas D'un Carcinome Basocellulaire Sous-cutanémentioning

confidence: 99%

“…Inadequate treatment will lead to recurrence and reconstructive difficulties that otherwise could have been avoided. The commonly accepted five-year recurrence rate varies widely between 5% to 40% and is a function of several tumour characteristics including location, histological subtype, tumour size and adequacy of resection (2)(3)(4). Although metastases are extremely rare, these lesions can invade by direct extension and may result in significant morbidity and even death by invasion into vital structures or from superimposed infections (8,9).…”

Section: Case Reportmentioning

confidence: 99%

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Subcutaneous basal cell carcinoma: A case report

Voris¹,

Quinn²

2003

J Plast Surg

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An unusual case of a patient who presented with a subcutaneous soft tissue lesion of the back is described. The patient had no preceding history of cutaneous malignancy or local trauma. Excision of the lesion revealed a diagnosis consistent with basal cell carcinoma with deep infiltration. The site was re-excised with a generous margin to ensure complete removal. There has been no recurrence for 18 months. This case is presented to underscore the rarity and importance of its existence.Key Words: Basal cell cancer; Subcutaneous; Subdermal Rapport de cas d'un carcinome basocellulaire sous-cutané Est décrit le cas inhabituel d'un patient qui s'est présenté avec une lésion des tissus mous sous-cutanés dans le dos. Le patient ne présentait aucun antécédent de malignité cutanée ou de traumatisme local. L'excision de la lésion a révélé un diagnostic confirmant la présence d'un carcinome basocellulaire avec infiltration profonde. Une nouvelle excision, comportant une marge plus importante, a été effectuée au foyer de la lésion afin d'en garantir l'extraction complète. Aucune récurrence ne s'est manifestée depuis 18 mois. Ce cas est présenté pour en souligner la rareté et l'importance. B asal cell carcinoma (BCC) is the most common cutaneous malignancy that humans acquire in the course of a lifetime (1). Approximately 85% of all BCCs appear in the head and neck region, with only 10% occurring in the torso and trunk (2,3). Basal cell lesions that occur in areas not exposed to the sun occasionally have a propensity for aggressive and locally invasive behavior. This characteristic underscores the importance of wide local excision to achieve excisional control and to avoid recurrence. The following report depicts an unusual case of a patient who presented with a subcutaneous soft tissue lesion of the back. Excision of the lesion revealed a diagnosis consistent with basal cell carcinoma with deep infiltration. CASE PRESENTATIONA 21-year-old white woman presented in June 2000 with a soft tissue mass near the midline of the upper back. The lesion had been slowly enlarging over the preceding six months to the point that it was noticeable to the patient during activities of daily living. There was no pain or tenderness associated with the mass. On physical examination, a 1.2 cm × 1.2 cm subcutaneous lesion was identified with no evidence of overlying skin abnormality. A presumptive diagnosis of lipoma was made followed by its direct excision. During the surgical resection, dissection was more arduous; the specimen exhibited a deeper color and did not have the discrete boundaries that are often seen with lipomas. Serial pathological sections revealed an intact epidermis with a deeply infiltrating BCC at the level of the dermis. The tumour reached both lateral lines of resection, including the deep subcutaneous margin. Mitotic figures were not attached to the epidermis. After confirmation of the diagnosis from a second pathologist, the patient was returned to the operating theatre for re-excision. A wide resection of the lesion was...

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Mohs surgery. Technique, indications, applications, and the future

Swanson¹

1983

Archives of Dermatology

126

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Each year, it is estimated, more than 500,000 new cases of nonmelanoma skin cancer develop. The majority of these cutaneous neoplasms are treated by various modalities that include excision, electrodesiccation and curettage, cryosurgery, and irradiation, with greater than 90% success. Certain of the remaining primary tumors, as well as recurrent carcinomas, present a demanding therapeutic challenge. For these lesions, Mohs surgery has evolved as the most reliable and cost-effective treatment modality, offering maximal preservation of normal tissue and therefore the lowest functional and cosmetic morbidity. In this review, the history and evolution of Mohs surgery and the technique itself will be briefly outlined. The indications for Mohs surgery, together with methods of handling the postoperative wound and future applications of the technique, will be discussed in detail.

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Basal Cell Carcinoma of the Head and Neck: Identification of the High Risk Patient

Cited by 96 publications

References 7 publications

Facial basal cell carcinoma: Analysis of recurrence and follow-up strategies

Facial basal cell carcinoma: Analysis of recurrence and follow-up strategies

Subcutaneous basal cell carcinoma: A case report

Mohs surgery. Technique, indications, applications, and the future

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