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Vulvar basal cell carcinoma: an infrequently metastasizing neoplasm
T Perrone1, L B Twiggs, L L Adcock
1Department of Laboratory Medicine and Pathology, University of Minnesota Medical School and Hospital, Minneapolis 55455.
Summary
Metastatic basal cell carcinoma (BCC) of the vulva is rare. Key features like advanced stage and deep invasion distinguish aggressive vulvar BCC, guiding treatment decisions for this uncommon cancer.
Area of Science:
- Dermatology
- Gynecologic Oncology
- Pathology
Background:
- Basal cell carcinoma (BCC) is a common skin cancer, rarely metastasizing.
- Vulvar BCC is exceptionally rare, with limited data on its behavior and metastatic potential.
Purpose of the Study:
- To present a case of metastasizing vulvar basal cell carcinoma.
- To compare clinicopathologic features of metastatic versus non-metastatic vulvar BCC.
- To review treatment strategies and nomenclature for vulvar BCC.
Main Methods:
- Case presentation of a metastasizing vulvar BCC.
- Comparative analysis of clinicopathologic parameters between one metastatic and ten non-metastatic vulvar BCCs.
- Literature review of previously reported cases and treatment options.
Main Results:
- The metastasizing vulvar BCC exhibited advanced stage, vaginal bleeding, invasion of subcutaneous fat, urethra, and vagina, thickness >1 cm, and morphealike growth.
- These features differentiated it from most non-metastatic vulvar BCCs.
- Vulvar BCC generally behaves like BCC elsewhere, with local recurrence being more common than metastasis.
Conclusions:
- Metastasizing vulvar BCC is rare but shares features with aggressive BCCs in other locations.
- Simple wide excision is curative for most cases; aggressive surgery may be needed for locally destructive, advanced tumors.
- Further investigation into "basosquamous" carcinoma and potential systemic syndromes is warranted.