Metastatic basal cell carcinoma: Case series and literature review

To present a metastatic head and neck basal cell carcinoma (BCC) series treated by a university teaching service between 1993 and 2021.

A review of medical records of 500 patients with high-risk BCC in the head and neck was performed. Tumors with a diameter greater than or equal to 6 mm in the "H" area of the face or greater than 10 mm in other head and neck areas; recurrences; sclerodermiform, micronodular and metatypical subtypes; and perineural invasion were considered factors indicating high-risk.

Seven cases of metastatic head and neck BCC were diagnosed. The mean age at diagnosis of the primary tumor was 49.8 years, and the median time between the diagnosis of the primary tumor and that of metastases was 3 years (ranging from 1 to 20 years). The main site of metastasis was the lymph nodes. The main modalities of metastases treatment were surgery and radiotherapy.

BCC metastasis is a rare manifestation of a frequent disease. Post-treatment follow-up should include routine clinical examination of the neck for all patients and imaging for the diagnosis of metastases in symptomatic patients.

Level IV.