Basal Cell Carcinoma

last authored: Sept 2009, David LaPierre

 

Introduction

Basal cell carcinoma: most common human malignant disease! Ulcerative lesion w rolled
borders and telangiectasias. Grows by local invasion (“rodent ulcer”), not by LN or
distant mets.

 

 

The Case of...

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Causes and Risk Factors

Fasting growing group is women under 40.

 

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Pathophysiology

 

Subtypes include:

 

 

Types (from most common:

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Signs and Symptoms

 

  • history
  • physical exam

History

 

Physical Exam

start up as papules-nodules-ulcerative

 

pearly/shiny

growing

Rolled-up borders

telangiectasias

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Investigations

  • lab investigations
  • diagnostic imaging

Lab Investigations

Diagnostic Imaging

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Differential Diagnosis

squamous cell carcinoma

actinic keratosis

melanoma (pigmented BCC can be confused with it)

 

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Treatments

Surgery is

Radiation

Chemotherapy or immiquimod (T Cell modulator) can be applied topically, especially for superficial BCC.

 

Rx: elecrodessic’n & curettage (derm), local excision (can use narrow
margins for most BCC), cryotherapy (liquid N), topical chemo, superficial RT or
immunotherapy (imiquimod/Aldara). MOH’S surgery for recurrent or high grade
tumours (e.g. morpheaform/sclerosing or neurotropic BCC).

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Consequences and Course

Metastasis is exceedingly rare, except in immunosuppressed patients, who even still have very rare rates of metastasis.

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The Case of...

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Additional Resources

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Topic Development

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