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Basal cell carcinoma with pulmonary and lymph node metastasis causing death
June K Robinson1, Madhu Dahiya
1Departments of Medicine and Pathology, Division of Dermatology, Cardinal Bernardin Cancer Center, Loyola University Stritch School of Medicine, 2160 S First Avenue, Rm 341, Maywood, IL 60153, USA. jrobin5@lumc.edu
Archives of Dermatology
|May 21, 2003
Summary
Metastatic basal cell carcinoma, though rare, can spread to lymph nodes and lungs. Dense microvessel accumulation was observed at tumor boundaries and within lymph node metastases.
Area of Science:
- Oncology
- Dermatopathology
Background:
- Metastatic basal cell carcinoma (BCC) incidence is low, ranging from 0.003% to 0.55%.
- Reported cases (230) often arise from long-standing, recurrent BCC lesions.
- Metastases commonly involve regional lymph nodes or the lungs.
Observation:
- Basal cell carcinoma's stromal dependence suggests a non-metastasizing nature.
- Dense fibrous stroma observed in a metastatic BCC lymph node case.
- Similar stromal characteristics noted in other BCC metastases to lymph nodes, bone, bone marrow, glands, and subcutaneous tissue.
Findings:
- The presented metastatic basal cell carcinoma exhibited both lymphatic and hematogenous dissemination.
- Metastatic spread occurred to the lungs and lymph nodes.
- A dense accumulation of microvessels was identified at tumor nest-dermal stroma boundaries and within the lymph node stroma.
Implications:
- Understanding BCC stromal interactions is crucial for predicting metastatic potential.
- Dense microvasculature may facilitate tumor dissemination.
- Further research into BCC angiogenesis and stromal factors is warranted.