When basal cell carcinomas became giant: an Italian multicenter study

Abstract

Background Giant basal cell carcinoma (GBCC) is a basal cell carcinoma (BCC) enlarged in a diameter more than 5 cm. Since GBCCs are a highly infrequent entity and the occurrence rate is approximately 0.5-1% out of all BCC types, only anecdotal cases are reported, and causes and characteristics inducing development of this tumor are not defined.Objectives Evaluate causative factors and clinico-histological characteristics of GBCCs.Methods The study is a 6-month, hospital-based case series study performed in 12 Italian dermatologic centers.Results A total of 59 cases and 458 control BCCs were collected. No significant differences existed between the two groups if we take into account social or cultural factors. The average duration of GBCCs is considerably longer than controls. GBCCs are located on unexposed areas while BCCs are on areas not usually covered by clothes. Superficial histological subtype was more frequent in the BCCs group, while infiltrative in GBCCs.GBCCs showed significantly higher local invasiveness, and greater metastatic capacity.More than half of GBCCs had been previously treated with one or more treatments.Conclusions Patients with GBCCs appear to belong to two categories: (i) those who present with GBCC due to delay in accessing medical attention, and (ii) those who have BCCs previously treated with inappropriate strategies. Very few cases could be due to intrinsically aggressive, refractory, or recurrent (after appropriately treated) BCCs. Social and cultural conditions do not appear to be involved in the development of GBCCS. These observations may help clinicians in selecting correct therapeutic strategies in the treatment of BCCs, which give rise to GBCC.

Neglected Fungating Giant basal cell carcinoma: A case report and literature review

“…Considering the histological variant, the most common low‐grade histological subtypes are superficial, followed by nodular, adenoid, etc., which has a low recurrence rate, and among the high‐grade, the most common is infiltrating, followed by mixed pattern, basosquamous, and morphea form 3,9 . Superficial histological subtypes are more frequent in the BCC groups, while giant BCC has infiltrative histology 10 . Hence, giant BCC is a rare variant that infiltrates the dermis and frequently involves underlying structures, often leading to metastasis and death 5 …”

Management of patients with giant basal cell carcinoma during SARS COV2 outbreak in Italy

“…The same PTCH1 gene is mutated at the germline level in the Basal Cell Nevus Syndrome (formerly Gorlin‐Goltz Syndrome) [ 7 ]. Its histogenesis is still a matter of debate, although it seems that most BCCs arise from the stem cells located in the hair follicle [ 2 , 8 , 9 , 10 , 11 ]. This observation could explain why BCC growth is restricted to skin with pilosebaceous units.…”

“…Imiquimod works by modifying the immune response, enhancing both innate and adaptive immune responses. Specifically, it binds to Toll‐like receptor 7 (TLR7) on anti‐gen‐presenting cells, activating the signaling cascade that stimulates the production of nuclear factor κB (NFκB), promoting APC maturation and enhancing Th1‐type response [ 9 , 10 ]. It was a valid therapeutic alternative in our patients and local skin reactions were well accepted by patients and caregivers.…”

Effect of tumor size on dermoscopic features of pigmented basal cell carcinoma

“…In addition, giant BCC has attracted the attention of researchers in recent years. [ 1 ] Thus, BCC with a large tumor size also catches our attention. Dermoscopy is a useful adjuvant tool for the diagnosis and management of BCCs.…”

“…Most BCC is an indolent kind of tumor, it can grow into a large lesion and lost its classic performance. In addition, giant BCC has attracted the attention of researchers in recent years [1] . Thus, BCC with a large tumor size also catches our attention.…”