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Metastatic basal cell carcinoma. Report of five cases
1Department of Human Oncology, University of Wisconsin Medical School, Madison.
Cancer
|January 15, 1994
Summary
Metastatic basal cell carcinoma (MBCC) rarely develops from small tumors. Large, deep basal cell carcinomas (BCC), especially on the face, significantly increase the risk of metastasis, requiring long-term patient follow-up.
Area of Science:
- Dermatology
- Oncology
- Surgical Pathology
Background:
- Metastatic basal cell carcinoma (MBCC) is a rare but serious condition.
- Risk factors include persistent, treatment-refractory basal cell carcinoma (BCC) and prior radiation therapy.
- Most MBCC cases originate from large primary tumors.
Purpose of the Study:
- To analyze the characteristics of primary tumors associated with metastatic basal cell carcinoma (MBCC).
- To evaluate the utility of the TNM classification system for BCC.
- To identify risk factors and predict the metastatic potential of BCC.
Main Methods:
- Case series of five patients with MBCC.
- Retrospective review of over 40 reports (65 patients) of MBCC from 1981-1991.
- Tabulation of primary tumor size and depth of invasion using TNM classification.
Main Results:
- The mean diameter of primary BCC in MBCC cases was 8.7 cm.
- Large (T2, T3) and deep (T4) BCCs accounted for approximately 75% of metastatic tumors.
- MBCC originating from facial sites comprised about 67% of cases.
Conclusions:
- BCCs larger than 3 cm have a 1.9% incidence of metastasis.
- Morpheaform BCC has a low metastasis rate (<1%).
- Patients with T3 and T4 BCC lesions require extended follow-up (10+ years) for potential MBCC development.