When basal cell carcinomas became giant: an Italian multicenter study

Area of Science:

• Dermatology
• Oncology
• Pathology

Background:

• Giant basal cell carcinoma (GBCC) is defined as a basal cell carcinoma (BCC) exceeding 5 cm in diameter.
• GBCCs are rare, accounting for only 0.5-1% of all BCCs, with limited data on their development.
• Causes and specific characteristics of GBCC development remain poorly understood.

Purpose of the Study:

• To investigate the causative factors of GBCC.
• To analyze the clinico-histological features of GBCC.

Main Methods:

• A 6-month, hospital-based case series study.
• Involved 12 Italian dermatologic centers.
• Collected data from 59 GBCC cases and 458 control BCCs.

Main Results:

• No significant social or cultural differences were found between GBCC and control groups.
• GBCCs had a longer duration, were located on unexposed areas, and were more frequently of the infiltrative histological subtype compared to BCCs.
• GBCCs demonstrated significantly higher local invasiveness, greater metastatic potential, and over half had prior treatments.

Conclusions:

• GBCC patients typically fall into two groups: those with delayed medical attention or those with previously inadequately treated BCCs.
• Intrinsic tumor aggressiveness is rarely the sole cause of GBCC.
• Social and cultural factors do not appear to influence GBCC development, guiding clinicians toward appropriate therapeutic strategies for BCCs that may progress to GBCC.