Invasive basal cell carcinoma of the head and neck (basalioma terebrans)

In a retrospective study, initial diagnosis and method of treatment were evaluated in 118 patients with invasive basal cell carcinoma (formerly basalioma terebrans) of the head and neck. In 97 of the total 118 patients, radical surgery with resection of important organs had to be performed, and the follow-up results of 107 patients were recorded. In 44 (41%) of the latter 107 cases, recurrences were observed despite radical tumor excision, and only 63 (59%) patients were free of tumor. In 20 patients a second recurrence and in 12 patients a third recurrence was found. The recurrence rate amounted to only 1.9% in a comparative study group of 6932 patients with "simple" basal cell carcinoma. The findings reveal that healing without recurrence was achieved in only half of the patients with invasive basal cell carcinoma (basalioma terebrans). In cases in which bony structures had been invaded by the tumor, the recurrence rate was 71.4%. Despite the hypothesis of primary incurability of invasive basal cell carcinoma, it is pointed out that radical surgery may still improve a patient's quality of life. Although definite healing seems impossible, surgery may contribute to an acceptable quality of life for several years.