Metastatic basal cell carcinoma: review, pathogenesis, and report of two cases

Abstract

In 93 reported cases of metastatic basal cell carcinoma (BCC), 76 had spread through lymphatics or blood vessels. Two more cases are presented, bringing the total to 78. Metastasis to regional lymph nodes was the most frequent, followed in frequency by lungs, bones, and other organs. The size of the primary tumor, its site, its resistance to x-ray therapy, and the effects of radiation appeared to contribute to the occurrence of metastasis. However, in an appreciable number of cases, tumor dissemination was related to incomplete excision followed by immediate wound closure, particularly by grafting. It is recommended that wound grafting be delayed for at least six months after excision or large or recurrent BCC in order to assure complete removal.

A Systematic Review of Treatment Modalities for Primary Basal Cell Carcinomas

“…Sometimes the tumors show strong destructive behavior, 16 high recurrence rates, and even metastasis. 17,18 Because BCCs can present in many different ways and situations, several thera-peutic modalities have been used to treat them. For selecting the best method to treat a specific BCC, a thorough knowledge of the modality, its complications and cosmetic results, and the recurrence rates is required.…”

Metastatic basal cell carcinoma – A dramatic case

“…In accordance with the slow growth of BCC, the mean duration from primary development to metastasis is approximately 10 to 12 years (7,10,12). However, after documented metastasis, the survival time is surprisingly short, with reports ranging from eight to 10 months (8,(12)(13)(14).…”

Metastatic basal cell carcinoma diagnosed by sentinel lymph node biopsy

“…11 Because BCC is not commonly reported to cancer registries in the United States, the true incidence cannot be determined, and reporting bias may have led to overestimation. The rarity of MBCC has been attributed to its stromal dependence, making it difficult to transplant without its tumor stroma 12 ; to decreased cell mobility because of pronounced microfilament formation in the basal layer 13 ; and to absence of intratumor microvasculature in most BCCs. 14 About half of MBCC cases have visceral (presumably hematogenous) metastases, and the remaining half have nodal metastases.…”