Kurian Rinsey Rose, Di Palma Silvana, Barrett A W
Department of Histopathology, Royal Surrey County Hospital (RSCH), Guildford, UK.
Head Neck Pathol. 2014;8(3):349-53. doi: 10.1007/s12105-013-0507-3. Epub 2013 Nov 15.
Metastasis from basal cell carcinoma of the skin is very rare with cases being documented in the lymph nodes, lung, bone and parotid gland. The main histopathological differential diagnosis is the locally arising basal cell adenocarcinoma from which it is difficult to distinguish by morphology and routine immunohistochemistry. Approximately 85 % of all reported metastatic basal cell carcinomas arise in the head and neck region. Here we present a case of basal cell carcinoma of the skin of the left lateral canthus of the eye which metastasized to the intraparotid lymph nodes with infiltration of the adjacent parotid parenchyma. More awareness and vigilance is required on the part of the reporting pathologist to consider metastasis in the presence of a parotid tumour. Features favouring metastasis include history of primary cutaneous basal cell carcinoma, histological similarity to the primary lesion and absence of any demonstrable direct extension from the skin lesion. We also review the literature on metastatic basal cell carcinoma and discuss the need for adequate follow up in high risk patients.
皮肤基底细胞癌转移极为罕见，有转移至淋巴结、肺、骨及腮腺的病例报道。主要的组织病理学鉴别诊断是局部发生的基底细胞腺癌，通过形态学和常规免疫组化很难将二者区分开来。所有报道的转移性基底细胞癌中，约85%发生于头颈部区域。在此，我们报告1例眼外眦部皮肤基底细胞癌转移至腮腺内淋巴结并侵犯相邻腮腺实质的病例。报告病理学家需要提高认识并保持警惕，在遇到腮腺肿瘤时考虑转移的可能。支持转移的特征包括原发性皮肤基底细胞癌病史、组织学与原发病变相似以及无皮肤病变的任何可证实的直接蔓延。我们还回顾了转移性基底细胞癌的文献，并讨论了高危患者进行充分随访的必要性。
