Metastatic basal cell carcinoma: Report of twelve cases with a review of the literature

Lo, Jacob S.; Snow, Stephen N.; Reizner, George T.; Mohs, Frederic E.; Larson, Paul O.; Hruza, George J.

doi:10.1016/0190-9622(91)70108-e

Cited by 332 publications

(233 citation statements)

References 49 publications

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“…17 Metastases are rare and most are said to more closely correlate to the size and depth and less so to the histologic subtype of the original tumor. [18][19][20] Lesions that recur after radiotherapy may infiltrate widely prior to becoming clinically apparent; this plus the fact that radiotherapy is often reserved for aggressive growth tumors ought to enhance the suspicion of perineural infiltration in recurrent BCC postirradiation. 19 The incidence of metastases and/or death is said to correlate to large tumors greater than 3 cm in diameter in which setting patients are said to have a 1-2% risk of metastases that increases to up to 20-25% in lesions greater than 5 cm and up to 50% in lesions greater than 10 cm in diameter.…”

Section: Clinical Featuresmentioning

confidence: 99%

Basal cell carcinoma: biology, morphology and clinical implications

2006

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Basal cell carcinoma (BCC) is the most common malignant neoplasm of humans. Rising dramatically in incidence in North America, as likely reflects changing habits of the population and a move from more northerly climes to the sunbelt of the Southern and Southwestern United States, the incidence is surely to rise even higher in the future. The last decade has seen significant advances in our understanding of BCC biology and novel approaches to therapy, which hinge upon accurate diagnosis and subclassification by pathologists. The purpose of this review article is to summate the research advances in our understanding of BCC biology and to acquaint pathologists and clinicians to the practical issues in BCC diagnosis and subclassification which flow there from.

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Section: Clinical Featuresmentioning

confidence: 99%

Basal cell carcinoma: biology, morphology and clinical implications

2006

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“…62 BCC most commonly metastasizes, in order of frequency, to the regional lymph nodes, lungs, bones, and skin. 17,62,93 The risk factors for development of metastatic BCC include persistent tumor (many years), increased depth of invasion, prior radiotherapy, BCC refractory to treatment, defective cellular immunity, and larger tumor size (> 5 cm in diameter), with a rate of 1.9% in tumors greater than 3 cm in diameter, approximately 50% for tumors greater than 10 cm in diameter, and 100% in BCC with a volume greater than 400 cm 2 . 7,87,93 Metastatic disease carries a poor prognosis; the mean duration of survival ranges from 8 months to 3.6 years.…”

Section: Basal Cell Carcinomamentioning

confidence: 99%

A systematic review of clinical outcomes for patients diagnosed with skin cancer spinal metastases

Goodwin

Sankey

Liu

et al. 2016

SPI

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OBJECT Surgical procedures and/or adjuvant therapies are effective modalities for the treatment of symptomatic spinal metastases. However, clinical results specific to the skin cancer spinal metastasis cohort are generally lacking. The purpose of this study was to systematically review the literature for treatments, clinical outcomes, and survival following the diagnosis of a skin cancer spinal metastasis and evaluate prognostic factors in the context of spinal skin cancer metastases stratified by tumor subtype. METHODS The authors performed a literature review using PubMed, Embase, CINAHL, and Web of Science to identify articles since 1950 that reported survival, clinical outcomes, and/or prognostic factors for the skin cancer patient population with spinal metastases. The methodological quality of reviews was assessed using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) tool. RESULTS Sixty-five studies met the preset criteria and were included in the analysis. Of these studies, a total of 25, 40, 25, and 12 studies included patients who underwent some form of surgery, radiotherapy, chemotherapy, or observation alone, respectively. Sixty-three of the 65 included studies were retrospective in nature (Class of Evidence [CoE] IV), and the 2 prospective studies were CoE II. Based on the studies analyzed, the median overall survival for a patient with a spinal metastasis from a primary skin malignancy is 4.0 months; survival by tumor subtype is 12.5 months for patients with basal cell carcinoma (BCC), 4.0 months for those with melanoma, 4.0 months for those with squamous cell carcinoma, 3.0 months for those with pilomatrix carcinoma, and 1.5 months for those with Merkel cell carcinoma (p < 0.0001). The overall percentage of known continued disease progression after spine metastasis diagnosis was 40.1% (n = 244/608, range 25.0%–88.9%), the rate of known recurrence of the primary skin cancer lesion was 3.5% (n = 21/608, range 0.2%–100.0%), and the rate of known spine metastasis recurrence despite treatment for all skin malignancies was 2.8% (n = 17/608, range 0.0%–33.3%). Age greater than 65 years, sacral spinal involvement, presence of a neurological deficit, and nonambulatory status were associated with decreased survival in patients diagnosed with a primary skin cancer spinal metastasis. All other clinical or prognostic parameters were of low or insufficient strength. CONCLUSIONS Patients diagnosed with a primary skin cancer metastasis to the spine have poor overall survival with the exception of those with BCC. The median duration of survival for patients who received surgical intervention alone, medical management (chemotherapy and/or radiation) alone, or the combination of therapies was similar across interventions. Age, spinal region, and neurological status may be associated with poor survival following surgery.

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“…The longest known survival is 25 years. 6 Figure 1 Spiculated soft tissue mass with strands of tissue (A) extending into the adjacent lung parenchyma, which is a feature of metastatic carcinoma …”

Section: Discussionmentioning

confidence: 99%

Cutaneous basal cell carcinoma with endobronchial metastasis

Sadr

Kerviler

Kang

2014

annals

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Although basal cell carcinoma is a very common malignancy, metastasis from this tumour is extremely rare. For this reason, many plastic surgeons, dermatologists and physicians dealing with skin malignancies consider this as a locally invasive malignancy. We present a rare case of metastatic basal cell carcinoma manifested as a bronchial tumour. This case highlights the fact that despite basal cell carcinoma's local invasive potential, the possibility of distant metastasis still exists and clinicians should therefore be cautious about interpreting extracutaneous symptoms. Chest physicians should always consider the possibility of this rare tumour in the lungs in patients with a history of large basal cell carcinomas in the head and neck region.

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Metastatic basal cell carcinoma: Report of twelve cases with a review of the literature

Cited by 332 publications

References 49 publications

Basal cell carcinoma: biology, morphology and clinical implications

Basal cell carcinoma: biology, morphology and clinical implications

A systematic review of clinical outcomes for patients diagnosed with skin cancer spinal metastases

Cutaneous basal cell carcinoma with endobronchial metastasis

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