Does the histopathological subtype of primary basal cell carcinoma predict the subtype of secondary tumours? What role do genetic mutations play?

Abstract

Background Basal cell carcinoma (BCC) is one of the most common malignancies in the world. The frequency of histopathological subtypes and the distribution on the body of BCC has been well documented. Less has been written on the nature of secondary tumours. The genetics of BCC is starting to be understood, particularly with the advent of newer medical treatments (hedgehog inhibitors). Objectives To determine if primary basal cell carcinoma histopathological subtype predicts secondary tumour subtype, as well as their anatomical distribution. Methods A retrospective case series of patients over the age of 18 was performed from 2009 to 2014, with at least two separate diagnoses of BCC. Results In 394 identified patients, a total of 1355 BCCs arose in the cohort over the 6‐year study period. The number of secondary BCCs per patient ranged from 2 to 19 tumours. Nodular BCC was the most likely to reoccur in secondary tumours (53.3%), followed by mixed subtypes (45.7%). Conclusions Within our study, we did find a predisposition for secondary BCCs to be of the same histopathological subtype as the primary, particularly with respect to nodular and mixed tumours. Furthermore, we found that secondary tumours were also more likely to occur on the same anatomical site as the primary tumour. We are only just beginning to under the genetic mutations involved in subtype formation.

Skin cancer special issue in Skin Health and Disease

“…In this special issue of Skin Health and Disease we aimed to highlight the complexity of skin cancers by publishing a wide array of manuscripts covering different aspects related to skin cancers, ranging from primary prevention strategies related to sun education, 11 genetics, 12 and epidemiology 13 , 14 , 15 , 16 to surgical 17 , 18 and non‐surgical 19 , 20 , 21 treatments. From these papers, we would like to highlight some hot topics such as the paper from Borg et al 17 evaluating the impact of the COVID‐19 pandemic in the surgical management of skin cancers on the head and neck area in elderly patients.…”