Neglected Basal Cell Carcinomas in the 21st Century

Abstract

Although tumors on the surface of the skin are considered to be easily recognizable, neglected advanced skin neoplasms are encountered even in the 21st century. There can be numerous causes of the delay in the diagnosis: fear of the diagnosis and the treatment, becoming accustomed to a slowly growing tumor, old age, a low social milieu, and an inadequate hygienic culture are among the factors leading some people not to seek medical advice. The treatment of such advanced neoplasms is usually challenging. The therapy of neglected cases demands an individual multidisciplinary approach and teamwork. Basal cell carcinoma (BCC), the most common cutaneous tumor, usually develops in the elderly, grows slowly, and has an extremely low metastatic potential; these factors are suggesting that BCCs might well be the “ideal candidates” for neglected tumors. Five neglected advanced cases of BCC were diagnosed in our dermatological institute between 2000 and 2009. The clinical characteristics and treatment modalities of these neoplasms are discussed, together with the possible causes of the neglect.

An aggressive Basal Cell Carcinoma with multiple focuses and distant lung metastasis: case report

“…Low level of knowledge about skin tumors may be the explanation in some cases and a low social milieu, inadequate hygienic culture associated with poverty. Slowly growing and old age, not painful neoplasm may also result in a delay in seeking medical advice [23]. Giant BCC presents some common epidemiological factors that include multiplicity of tumors, race, development on suncovered areas, neglect and tumor chronicity.…”

Counterpoint: Limited life expectancy, basal cell carcinoma, health care today, and unintended consequences

“…We know that BCC is presenting more frequently in our elderly population and often is not considered at the time of evaluation. 7 Varga et al 7 suggested that BCCs ''may be the ideal candidates for neglected tumors'' and others 8,9 studied factors contributing to delayed diagnosis. The proposed algorithm may contribute to the unintended consequence of BCCs presenting at an advanced stage and incurring increased morbidity for the patient and increased health care costs.…”

Basal Cell Carcinoma

“…Giant BCC is rarely seen and constitute 1% of all cases of BCC. Rates of local invasion and metastasis of making Giant BCC is higher (Varga et al, 2011). Early diagnosis and treatment can not be done in cases of localized BCC.…”