Spontaneous Regression of Two Giant Basal Cell Carcinomas in a Single Patient after Incomplete Excision

Rieger, Ulrich M.; Schlecker, Christina; Pierer, Gerhard; Haug, Martin

doi:10.1177/030089160909500223

Cited by 11 publications

(11 citation statements)

References 37 publications

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“…Our study demonstrated an association between CD3ε, CD25, CD68, and ICAM-1 mRNA levels in BCC tumor biopsies and the risk for subsequent tumors. These results support an important role for inflammatory cells in the peri-tumoral milieu and for immune cells that infiltrate BCC tumors and thus mediate BCC tumor progression [12], [13], [20].…”

Section: Discussionsupporting

confidence: 67%

Tumor Site Immune Markers Associated with Risk for Subsequent Basal Cell Carcinomas

et al. 2011

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BackgroundBasal cell carcinoma (BCC) tumors are the most common skin cancer and are highly immunogenic.ObjectiveThe goal of this study was to assess how immune-cell related gene expression in an initial BCC tumor biopsy was related to the appearance of subsequent BCC tumors.Materials and MethodsLevels of mRNA for CD3ε (a T-cell receptor marker), CD25 (the alpha chain of the interleukin (IL)-2 receptor expressed on activated T-cells and B-cells), CD68 (a marker for monocytes/macrophages), the cell surface glycoprotein intercellular adhesion molecule-1 (ICAM-1), the cytokine interferon-γ (IFN-γ) and the anti-inflammatory cytokine IL-10 were measured in BCC tumor biopsies from 138 patients using real-time PCR.ResultsThe median follow-up was 26.6 months, and 61% of subjects were free of new BCCs two years post-initial biopsy. Patients with low CD3ε CD25, CD68, and ICAM-1 mRNA levels had significantly shorter times before new tumors were detected (p = 0.03, p = 0.02, p = 0.003, and p = 0.08, respectively). Furthermore, older age diminished the association of mRNA levels with the appearance of subsequent tumors.ConclusionsOur results show that levels of CD3ε, CD25, CD68, and ICAM-1 mRNA in BCC biopsies may predict risk for new BCC tumors.

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Section: Discussionsupporting

confidence: 67%

Tumor Site Immune Markers Associated with Risk for Subsequent Basal Cell Carcinomas

et al. 2011

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“…Though many risk factors for GBCCs are similar to those for BCCs (e.g., Caucasian race, prior history of BCC, and exposure to ultraviolet radiation), a distinct feature of GBCC is a patient's neglect of the lesion and a resulting delay in effective intervention [3, 5, 8, 9]. …”

Section: Discussionmentioning

confidence: 99%

“…A common trend among cases of GBCC is patients’ distrust of contemporary Western medicine [3, 5, 8]. Previous case reports of multiple GBCCs also described patients with established beliefs in holistic or religious treatments [3, 5, 8].…”

Section: Discussionmentioning

confidence: 99%

“…Previous case reports of multiple GBCCs also described patients with established beliefs in holistic or religious treatments [3, 5, 8]. In some instances, patients that experienced BCC recurrence after surgical excision were frustrated by the outcome and rejected all further care, leading to progression and death from associated complications [10].…”

Section: Discussionmentioning

confidence: 99%

“…Due to their large size and tendency to infiltrate neighboring muscle, nerve, and bone, these lesions are often disfiguring and disabling. The presence of 2 coexisting GBCCs in the same individual is rare, with few reported cases [3, 4, 5, 6]. Here we present a patient with 2 GBCCs located symmetrically on the bilateral forearms.…”

Section: Introductionmentioning

confidence: 87%

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Giant Basal Cell Carcinomas Arising on the Bilateral Forearms of a Patient: A Case Report and Review of Nonsurgical Treatment Options

et al. 2016

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Giant basal cell carcinomas (GBCCs) are large basal cell carcinomas (BCCs; <5 cm) with a greater propensity to invade and metastasize than standard BCCs. The presence of 2 GBCCs in a single individual is rare. We present the case of a 71-year-old Caucasian male with bilateral GBCCs on the dorsal forearms, measuring 130 cm² and 24 cm², respectively, that developed over a 21-year period. Over this period, the patient treated the tumors with herbal remedies. Histologic evaluation showed a conventional nodular BCC for both tumors. Computed tomography and magnetic resonance imaging revealed a T4N0M0 stage for the larger lesion. Surgical excision and grafting and reconstruction were offered, but he declined. This case highlights a shared belief in holistic treatments and rejection of Western medical interventions that are common among many patients with GBCC. Studies reporting nonsurgical treatments for GBCCs, including radiotherapy, vismodegib, topical imiquimod, and acitretin are reviewed.

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Basal Cell Carcinoma

Fagundes¹,

Glaser

Johnson

et al. 2012

Arch Gen Psychiatry

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Context Child emotional maltreatment can result in lasting immune dysregulation that may be heightened in the context of more recent life stress. Basal cell carcinoma (BCC) is the most common skin cancer, and the immune system plays a prominent role in tumor appearance and progression. Objective To address relationships among recent severe life events, childhood parental emotional maltreatment, depression, and messenger RNA (mRNA) coding for immune markers associated with BCC tumor progression/regression. Setting University medical center Design We collected information about early parent-child experiences, severe life events in the last year as assessed by the Life Events and Difficulties Schedule (LEDS), depression, and mRNA for immune markers associated with BCC tumor progression/regression from BCC tumor patients. Participants 91 BCC patients (ages 23–92) who had all had a previous BCC tumor. Main Outcome Measures The expression of four BCC tumor mRNA markers (CD25, CD3ε, ICAM-1, and CD68) that have been linked to BCC tumor progression/regression were assessed in BCC tumor biopsies. Results Both maternal and paternal emotional maltreatment interacted with the occurrence of severe life events to predict the local immune response to the tumor (adjusted p=0.009, p=0.03, respectively). Among BCC patients who had experienced a severe life event within the past year, those who were emotionally maltreated by their mothers (p=0.007) or fathers (p=0.02) as children had a poorer immune response to the BCC tumor. Emotional maltreatment was unrelated to BCC immune responses among those who did not experience a severe life event. Depressive symptoms were not associated with the local tumor immune response. Conclusions Troubled early parent-child relationships, in combination with a severe life event in the past year, predicted immune responses to a BCC tumor. The immunoreactivity observed in BCCs and the surrounding stroma reflects an anti-tumor-specific immune response that can be altered by stress.

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Spontaneous Regression of Two Giant Basal Cell Carcinomas in a Single Patient after Incomplete Excision

Cited by 11 publications

References 37 publications

Tumor Site Immune Markers Associated with Risk for Subsequent Basal Cell Carcinomas

Tumor Site Immune Markers Associated with Risk for Subsequent Basal Cell Carcinomas

Giant Basal Cell Carcinomas Arising on the Bilateral Forearms of a Patient: A Case Report and Review of Nonsurgical Treatment Options

Basal Cell Carcinoma

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