Linear Basal Cell Carcinoma: Report of Seventeen Cases and Review of the Presentation and Treatment

Abstract

Linear basal cell carcinoma is an uncommonly recognized morphologic variant. Based on the small number of cases, these tumors have more aggressive histologic subtypes. Because of the possibility for increased subclinical spread, Mohs micrographic surgery can be considered for treatment. Further studies are needed to confirm these findings.

Basal cell carcinoma and World War II–era cathode ray oscilloscope exposure

“…This percentage is much higher than the 6% of aggressive subtypes expected in the general population. 23 Moreover, we determined that the average number of Mohs layers needed to achieve negative margins for the BCCs in our study was 1.99. This was significantly higher (P \ .002) than the 1.63 average Mohs layers of the comparison group, treated by the same Mohs micrographic surgeon.…”

“…24 This increase in layers required to achieve a tumor-free plane indicates an increase in subclinical spread of the tumors. [23][24][25] In addition, it is important to note that of the 30 BCCs that required 3 or more Mohs layers to obtain tumor-free margins, 10 were aggressive subtypes, and that all but 4 of the 30 BCCs that required 3 or more Mohs layers were smaller than 1 cm in diameter on initial clinical examination (with 8 of the lesions less than 0.5 cm). The final tumor-free margined defects that resulted from these clinically small lesions averaged 1.6 3 2.1 cm, further indicating considerable subclinical extension of the tumors.…”

“…We propose that MMS may be a superior therapeutic option to remove these aggressive tumors and avoid incomplete resection through methods such as curettage, cryotherapy, or wide excision. 23,[25][26][27] In addition, we would recommend scheduling more frequent check-up visits aimed at early nonmelanoma skin cancer detection in such patients.…”

The Tissue Efficiency of Common Reconstructive Design and Modification

“…In addition, tumor growth may not always be uniform or circular, 16 and surgical defects are rarely perfectly circular, particularly after the precision of Mohs micrographic surgery. The shape of a defect greatly influences the potential reconstructive options for complex wounds, and incorporating any irregularities of the defect into design considerations can provide additional tissue conservation.…”

Metastatic basal cell carcinoma presenting with unilateral upper extremity edema and lymphatic spread

“…Other features of MBCC include initial size larger than 3.0 cm, tumor thickness more than 1.0 cm, and local ulceration. 5,10 MBCC most commonly involves the lymphatic system, lungs, bone, and skin. Evidently, BCC rarely metastasizes because of its dependence on surrounding stroma, as demonstrated by the inability to transplant BCC without surrounding tissue into other humans or animals.…”