Basal cell carcinoma natural history
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Saarah T. Alkhairy, M.D.
Overview
It is a slow-growing locally invasive lesion with an unlikely risk of metastasis. Most patients are often asymptomatic.
Natural History
- Patients with basal cell carcinoma are often asymptomatic[1]
- They often report a slowly enlarging lesion which does not heal and bleeds when traumatized
- It is locally invasive and destructive so the name rodent cancer
- The overall risk of metastases is estimated to be less than 0.1%
- The risk of invasion and recurrence is based on size, duration, location and subtype (sclerodermiform/morpheaform and micronodular clinical variants have a higher risk)
- Even without a recurrence, a personal history of basal cell carcinoma increases the risk of developing all types of skin cancers
Complications
- The main complication of basal cell carcinoma is recurrence[2][3]
- The following are the factors associated with increased risk of basal cell carcinoma recurrence:
- Location and size
- >/= 6 mm in diameter in high-risk areas (eg, central face, nose, lips, eyelids, eyebrows, periorbital skin, chin, mandible, ears, preauricular and postauricular areas, temples, hands, feet)
- 10 mm in diameter in other areas of the head and neck
- 20 mm in diameter in all other areas (excluding hands and feet)
- Aggressive pathologic variants
- Morpheaform, sclerosing, or mixed infiltrative
- Micronodular
- Basosquamous
- Lesions in sites of prior radiation therapy (RT)
- Lesions with poorly defined borders
- Lesions in immunocompromised patients
- Perineural invasion
- Location and size
Prognosis
- Prognosis of basal cell carcinoma is usually excellent[4][5].
- These lesions are typically slow growing, and metastatic disease is a very rare event.
- Basal cell carcinoma will cause considerable disfigurement by locally destroying skin, cartilage, and even bone.
- Recurrence is a issue with basal cell carcinoma.
- Approximately 50% of recurrences are apparent within the first two years.
References
- ↑ Wong CS, Strange RC, Lear JT (October 2003). "Basal cell carcinoma". BMJ. 327 (7418): 794–8. doi:10.1136/bmj.327.7418.794. PMC 214105. PMID 14525881.
- ↑ Wortsman, X.; Vergara, P.; Castro, A.; Saavedra, D.; Bobadilla, F.; Sazunic, I.; Zemelman, V.; Wortsman, J. (2015). "Ultrasound as predictor of histologic subtypes linked to recurrence in basal cell carcinoma of the skin". Journal of the European Academy of Dermatology and Venereology. 29 (4): 702–707. doi:10.1111/jdv.12660. ISSN 0926-9959.
- ↑ Jebodhsingh KN, Calafati J, Farrokhyar F, Harvey JT (April 2012). "Recurrence rates of basal cell carcinoma of the periocular skin: what to do with patients who have positive margins after resection". Can. J. Ophthalmol. 47 (2): 181–4. doi:10.1016/j.jcjo.2012.01.024. PMID 22560426.
- ↑ Czarnecki, D. (1998). "The prognosis of patients with basal and squamous cell carcinoma of the skin". International Journal of Dermatology. 37 (9): 656–658. doi:10.1046/j.1365-4362.1998.00559.x. ISSN 0011-9059.
- ↑ Correia de Sá TR, Silva R, Lopes JM (November 2015). "Basal cell carcinoma of the skin (part 2): diagnosis, prognosis and management". Future Oncol. 11 (22): 3023–38. doi:10.2217/fon.15.245. PMID 26449265.