Eruptive Basaliomas: ʺWhy we have to Perform Surgery? ʺ Or Said Otherwise: ʺCatch The Metatypical! ʺ

  • Ivanka Temelkova Medical Institute of Ministry of Interior (MVR), Department of Dermatology, Venereology and Dermatologic Surgery, Sofia
  • Hristo Mangarov Medical Institute of Ministry of Interior (MVR), Department of Dermatology, Venereology and Dermatologic Surgery, Sofia
  • Michael Tronnier Helios Klinikum GMBH, Dermatology, Venereology and Allergology, Hildesheim
  • Ivan Terziev Universitetska Mnogoprofilno Bolnitsa za Aktivno Lechenie Tsaritsa Yoanna, Common and Clinical Pathology, Sofia
  • Georgi Tchernev Medical Institute of Ministry of Interior (MVR), Department of Dermatology, Venereology and Dermatologic Surgery, Sofia; Onkoderma, Policlinic for Dermatology and Dermatologic Surgery General Skobelev 26, Sofia
Keywords: Basal cell carcinoma, Metatypical basal cell carcinoma, Radiation, Surgery

Abstract

BACKGROUND: Keratinocyte cancers are malignant diseases with a broad incidence of spread which tends to increase during the last couple of decades. The solar radiation plays a dominant role in the occurrence of BCC, but certain genetic phenotypes appear to be risky from an etiological point of view. Metatypical basal cell carcinoma (MTBCC) is a rare variant of BCC which combines the clinical and histological characteristics of BCC and SCC. Clinically they are indistinguishable from the conventional BCC, and only the histological examination can differentiate them. The MTBCC is a histological subtype which is considered more aggressive due to its ability to produce local recurrences or distant metastases.

CASE REPORT: We present a 44-year old patient with multiple BCCs disseminated on the face and body. The biopsy established mixed type histology: three metatypical and four solid BCCs. The lesions were removed via elliptical excision with a field of operational security of 0.5 cm in all directions.

CONCLUSIONS: The eruptive (multiple) BCCs are a challenge about the choice of a therapy option. This is because clinically completely identical tumours show different histopathological characteristics, namely those with a tendency to metastasise. Having in mind one of the hypotheses of metatypical BCC emergence - the improper or inadequate radiotherapy (as a choice of therapy) could trigger the transition of a conventional tumour to a metastasising one, the surgical treatment appears to be the most secure treatment method.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

Plum Analytics Artifact Widget Block

References

Wong C, Strange R, Lear J. Basal cell carcinoma. BMJ. 2003; 327(7418):794–798. https://doi.org/10.1136/bmj.327.7418.794 PMid:14525881

Gallagher R, Hill G, Bajdik C. Sunlight Exposure, Pigmentary Factors, and Risk of Nonmelanocytic Skin Cancer. Arch Dermatol. 1995; 131(2):157-163. https://doi.org/10.1001/archderm.1995.01690140041006

Tchernev G, Ananiev J, Cardoso J, Wollina U. Metatypical Basal Cell Carcinomas: a Successful Surgical Approach to Two Cases with Different Tumor Locations. Maedica (Buchar). 2014; 9(1):79–82.

Martin R, Edwards M, Cawte T, Sewell C, McMasters K. Basosquamous carcinoma: analysis of prognostic factors influencing recurrence. Cancer. 2000; 88(6):1365-9. https://doi.org/10.1002/(SICI)1097-0142(20000315)88:6<1365::AID-CNCR13>3.0.CO;2-Y

Snow S, Sahl W, Lo S, Mohs E, Warner T, Dekkinga A, Feyzi J. Metastatic basal cell carcinoma. Report of five cases. Cancer. 1994; 73(2):328-35. https://doi.org/10.1002/1097-0142(19940115)73:2<328::AID-CNCR2820730216>3.0.CO;2-U

Martin R, Edwards J, Cawte G, Sewell L, McMasters M. Basosquamous carcinoma: analysis of prognostic factors influencing recurrence. Cancer. 2000; 88(6):1365-9. https://doi.org/10.1002/(SICI)1097-0142(20000315)88:6<1365::AID-CNCR13>3.0.CO;2-Y

Ramachandran S, Fryer A, Lovatt T, Lear J, Smith A, Strange R. Susceptibility and modifier genes in cutaneous basal cell carcinomas and their associations with clinical phenotype. J Photochem Photobiol B. 2001; 63(1-3):1-7. https://doi.org/10.1016/S1011-1344(01)00194-4

Ramachandran S, Fryer A, Smith A, Lear J, Bowers B, Jones W, Strange R. Cutaneous basal cell carcinomas: distinct host factors are associated with the development of tumours on the trunk and the head and neck. Cancer. 2001; 92(2):354-8. https://doi.org/10.1002/1097-0142(20010715)92:2<354::AID-CNCR1330>3.0.CO;2-F

Neale R, Davis M, Pandeya N, Whiteman D, Green A. Basal cell carcinoma on the trunk is associated with excessive sun exposure. J Am Acad Dermatol. 2007; 56(3):380-6. https://doi.org/10.1016/j.jaad.2006.08.039

Pellegrini C, Maturo M, Nardo L, Ciciarelli V, García-Rodrigo C, Fargnoli M. Understanding the Molecular Genetics of Basal Cell Carcinoma. Int J Mol Sci. 2017; 18(11):2485. https://doi.org/10.3390/ijms18112485

Madan V, Hoban P, Strange R, Fryer A, Lear J. Genetics and risk factors for basal cell carcinoma. Br J Dermatol. 2006; 154(Suppl 1):5-7. https://doi.org/10.1111/j.1365-2133.2006.07229.x

Nakayama M, Tabuchi K, Nakamura Y, Hara A. Basal cell carcinoma of the head and neck. J Skin Cancer. 2011; 2011:496910. https://doi.org/10.1155/2011/496910

Tarallo M, Cigna E, Frati R, Delfino S, Innocenzi D, Fama U, Corbianco A, Scuderi N. Metatypical basal cell carcinoma: a clinical review. J Exp Clin Cancer Res. 2008; 27:65. https://doi.org/10.1186/1756-9966-27-65 PMid:18992138

30. Martin R, Edwards M, Cawte T, Sewell C, McMasters K. Basosquamous carcinoma: analysis of prognostic factors influencing recurrence. Cancer. 2000; 88(6):1365-9. https://doi.org/10.1002/(SICI)1097-0142(20000315)88:6<1365::AID-CNCR13>3.0.CO;2-Y

Tarallo M, Cigna E, Frati R, Delfino S, Innocenzi D, Fama U, Corbianco A, Scuderi N. Metatypical basal cell carcinoma: a clinical review. Journal of Experimental & Clinical Cancer Research. 2008; 27(1):65. https://doi.org/10.1186/1756-9966-27-65

Domarus H, Stevens J. 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. https://doi.org/10.1016/S0190-9622(84)80334-5

McGregor S, Minni J, Herold D. Superficial Radiation Therapy for the Treatment of Nonmelanoma Skin Cancers. J Clin Aesthet Dermatol. 2015; 8(12):12–14. PMCid:PMC4689506

Published
2018-07-30
How to Cite
1.
Temelkova I, Mangarov H, Tronnier M, Terziev I, Tchernev G. Eruptive Basaliomas: ʺWhy we have to Perform Surgery? ʺ Or Said Otherwise: ʺCatch The Metatypical! ʺ. Open Access Maced J Med Sci [Internet]. 2018Jul.30 [cited 2020Nov.29];6(8):1435-7. Available from: https://www.id-press.eu/mjms/article/view/oamjms.2018.203
Section
C- Case Reports

Most read articles by the same author(s)