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

Abstract

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 entity, and the presence of metastasis, although infrequent, must be proposed because of the greater morbidity and mortality of this complication. This case shows the importance of early diagnosis and intervention in BCC as a way to avoid unfavorable outcomes.

Basosquamous Carcinoma: A Single Centre Clinicopathological Evaluation and Proposal of an Evidence-Based Protocol

“…[ 2 ] reported five lymph node metastases in a series of 89 patients, with progression-free survival time averaging 16.1 months (range: 8.1-24.1 months); of these, two patients had pT1/pT2 tumours, with the remaining three having pT3/pT4 disease. BCC is known to very rarely metastasise [ 20 , 32 ].…”

Basal cell carcinoma

“…BCCs rarely metastasise, a feature which differentiates them from other forms of skin cancer. Metastases occur in less than 0.55% of BCCs, with the most common sites being lymph nodes, lungs, bone and other locations in the skin (Piva de Freitas et al., 2017). Although BCCs rarely metastasise, left untreated they can spread through soft tissue planes, becoming locally invasive and destroying local tissues and the underlying skeleton (PCDS, 2011).…”

Overview of genetic signaling pathway interactions within cutaneous malignancies

“…Compared to BCC, BSC has a higher tendency for local recurrence and a higher propensity for lymph node and distant metastases [121,127] . BSC comprises approximately 2% of all skin cancers with a metastasis rate of about 7% [128] compared with a metastasis rate of BCC of 0.0028%-0.55% [127,129] and of SCC of 2%-5% [130] . The BSC recurrence rate is 12%-51% after standard surgical excision [128] .…”