Metastatic basal cell carcinoma: case series and literature review
Mariana Gonçalves Rodrigues, Aline Vieira de Lucena, Gabriela Alves Domingues, Caroline Marques de Aquino, Deborah Yukiko Otto, Luiz Paulo Kowalski, André Bandiera de Oliveira Santos
Abstract
Introduction: Basal cell carcinoma (BCC) is the most common neoplasm in humans, with more than 10 million new cases per year worldwide. Despite its high incidence, the occurrence of regional and distant metastases is rare, with only 915 cases reported. Objective: To present a metastatic head and neck BCC series treated by a university teaching service between 1993 and 2021. Methods: 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. Results: 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 1–20 years). The main site of metastasis was the lymph nodes. The main modalities of metastases treatment were surgery and radiotherapy. Conclusion: 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.
Keywords
References
1. Peris K, Fargnoli MC, Garbe C, Kaufmann R, Bastholt L, Seguin NB, Bataille V, Marmol VD, Dummer R, Harwood CA, Hauschild A, Höller C, Haedersdal M, Malvehy J, Middleton MR, Morton CA, Nagore E, Stratigos AJ, Szeimies RM, Tagliaferri L, Trakatelli M, Zalaudek I, Eggermont A, Grob JJ, European Dermatology Forum (EDF), the European Association of Dermato-Oncology (EADO) and the European Organization for Research and Treatment of Cancer (EORTC). Diagnosis and treatment of basal cell carcinoma: European consensus–based interdisciplinary guidelines. Eur J Cancer. 2019;118:10-34. http://dx.doi.org/10.1016/j.ejca.2019.06.003. PMid:31288208.
2. Bisceglia M, Panniello G, Galliani CA, Centola M, D’Errico MM, Minenna E, Tucci FA, Ben-Dor DJ. Metastatic basal cell carcinoma of the skin: A comprehensive literature review, including advances in molecular therapeutics. Adv Anat Pathol. 2020;27(5):331-53. http://dx.doi.org/10.1097/PAP.0000000000000267. PMid:32618586.
3. Jacob A. Observations respecting an ulcer of peculiar character, which attacks the eye-lids and other parts of the face. Dublin; 1827.
4. Lattes R, Kessler RW. Metastasizing basal-cell epithelioma of the skin; report of two cases. Cancer. 1951;4(4):866-78. http://dx.doi. org/10.1002/1097-0142(195107)4:43.0.CO;2-F.
5. McCusker M, Basset-Seguin N, Dummer R, Lewis K, Schadendorf D, Sekulic A, Hou J, Wang L, Yue H, Hauschild A. Metastatic basal cell carcinoma: Prognosis dependent on anatomic site and spread of disease. Eur J Cancer. 2014;50(4):774- 83. http://dx.doi.org/10.1016/j.ejca.2013.12.013. PMid:24412051.
6. Snow SN, Sahl W, Lo JS, Mohs FE, Warner T, Dekkinga JA, Feyzi J. Metastatic basal cell carcinoma. report of five cases. Cancer. 1994;73(2):328-35. http://dx.doi. org/10.1002/1097-0142(19940115)73:23.0.CO;2-U. PMid:8293396.
7. Saldanha G, Fletcher A, Slater DN. Basal cell carcinoma: a dermatopathological and molecular biological update. Br J Dermatol. 2003;148(2):195-202. http:// dx.doi.org/10.1046/j.1365-2133.2003.05151.x. PMid:12588368.
8. Moser S, Borm J, Mihic-Probst D, Jacobsen C, Kruse Gujer AL. Metastatic basal cell carcinoma: report of a case and review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol. 2014;117(2):e79-82. http://dx.doi.org/10.1016/j. oooo.2012.04.030. PMid:23313228.
9. Uzquiano MC, Prieto VG, Nash JW, Ivan DS, Gong Y, Lazar AJ, Diwan AH. Metastatic basal cell carcinoma exhibits reduced actin expression. Mod Pathol. 2008;21(5):540-3. http://dx.doi.org/10.1038/modpathol.3801051. PMid:18223552.
10. Farmer ER, Helwig EB. Metastatic basal cell carcinoma: a clinicopathologic study of seventeen cases. Cancer. 1980;46(4):748-57. http://dx.doi.org/10.1002/1097- 0142(19800815)46:43.0.CO;2-K. PMid:7397637.
11. von Domarus H, Stevens PJ. Metastatic basal cell carcinoma: report of five cases and review of 170 cases in the literature. J Am Acad Dermatol. 1984;10(6):1043- 60. http://dx.doi.org/10.1016/S0190-9622(84)80334-5. PMid:6736323.
12. Tavin E, Persky MS, Jacobs J. Metastatic basal cell carcinoma of the head and neck. Laryngoscope. 1995;105(8 Pt 1):814-7. http://dx.doi.org/10.1288/00005537- 199508000-00008. PMid:7630292.
13. Tang S, Thompson S, Smee R. Metastatic basal cell carcinoma: case series and review of the literature. Australas J Dermatol. 2017;58(2):e40-3. http://dx.doi. org/10.1111/ajd.12459. PMid:26916335.
Submitted date:
10/27/2022
Accepted date:
02/07/2022
Facebook
Google+
Twitter
LinkedIn
Mendeley
StumbleUpon
CiteULike
Reddit
Email