Metastatic Basal Cell Carcinoma Presenting as Unilateral Axillary Lymphadenopathy: Report of a Case and Review of the Literature

Abstract

We report an unusual case of MBCC arising from a small, nonfacial primary BCC that presented with unilateral axillary lymphadenopathy.

Metastatic Basal Cell Carcinoma: A Case Report

“…BCC's of the face and scalp are thought to have a greater tendency to metastasise because of the increased concentration of large-calibre vessels [4].The incidence of metastatic spread has been reported as 2% in BCC's with a diameter larger than 3 cm, 25% for diameters larger than 5 cm and 50% for tumors with a diameter larger than 10 cm [4]. The most common sites of metastasis are the regional lymph nodes, followed by the lungs and bones [4][5][6]. Metastatic spread to skin, liver, and pleura has also been observed, but is less common [7].…”

Basal Cell Carcinoma

“…Metastatic BCC is extremely rare. Rates reported in the literature of metastatic BCC are between 0.0028% and 0.5% (Berlin et al, 2002;Cotran, 1961;Malone et al, 2000). Criteria for the diagnosis of metastatic BCC were first described in 1951 by Lattes and Kessler.…”

“…The most common areas of metastasis are lymph nodes, lungs, bone, skin (Berlin et al, 2002), and parathyroid glands (Wadhera et al, 2006). 85-90% of metastatic BCC is due to head and neck region (Wadhera et al, 2006).…”

Letters to the Editor

“…1 Risk factors that should lead to a higher index of suspicion among clinicians for identifying MBCC include large tumour size, significant tumour depth, previous irradiation, recurrence, immunocompromised patients, and primary BCC of the head and neck. 3,4 Even though higher rates of metastasis occur from primary lesions on the face, scalp and genitalia, MBCC arising from a primary tumour less than 2 cm in diameter is extremely infrequent. 4 Risk of metastasis has been further shown to specifically correlate with the size of the primary tumour: tumours greater than 3 cm conferring 2% risk, greater than 5 cm conferring 25% risk, and greater than 10 cm conferring 50% risk.…”

“…3,4 Even though higher rates of metastasis occur from primary lesions on the face, scalp and genitalia, MBCC arising from a primary tumour less than 2 cm in diameter is extremely infrequent. 4 Risk of metastasis has been further shown to specifically correlate with the size of the primary tumour: tumours greater than 3 cm conferring 2% risk, greater than 5 cm conferring 25% risk, and greater than 10 cm conferring 50% risk. 3 Except for their location, none of the cases of DeAmbrosis et al exhibit any of the recognizable risk factors for MBCC (with the exception of case 1, which presents squamous differentiation).…”