Rasulić Lukas G, Jovanović Milan D
Vojnosanit Pregl. 2014 Nov;71(11):1045-8. doi: 10.2298/vsp1411045r.
BACKGROUND/AIM: Basal cell carcinoma (BCC) is one of the most common malignant skin tumors on the head in 90% of cases and is characterized by a high local infiltrating potential and destructive growth. The aim of this study was to show the characteristics of a correlation between pathohistological types of basal cell carcinoma and the size of this lesion, aggressiveness and infiltration of basal cell carcinoma, and its effect on the course of the therapy.
We analyzed 27 patients operated on for BCC that affected the scalp and the bone. We described and considered the clinical characteristics (size, depth of invasion), duration and speed of intracranial propagation and then made comparison with the type of BCC. We described the extent of surgical treatment and the width of excision to determine the best course of the treatment. The patients went through examinations during the next three years.
According to the histopathological type the most common tumors were: infiltrative (60.2%), noduloinfiltrative (37.2%), and morpheaform (2.6%). Tumors were clinically manifested as ulcerative lesions, ulcus rodens and ulcus terebrans. Tumor diameters ranged from 2 to 25 cm. The depth of intracranial propagation depended on the histological type and tumor size. Most relapses (35%) occurred with morpheaform type of BCC. In 17 of the cases, BCC affected the bone without intracranial propagation. In 10 of the cases, basalioma infiltrated intracranial space--in 8 of the cases it infiltrated the dura and in 6 of the cases the brain parenchyma, of which in two of them, the superior sagittal sinus was affected and had to be surgically tied off.
The aggressiveness and infiltration of basal cell carcinoma into the brain parenchyma is directly linked to the histological type and the size of the tumor. The larger the basalioma or if histopathological findings confirm morpheaform type of basalioma the larger surrounding healthy tissue, sometimes more than 3 cm in diameter, needs to be removed. In cases of these tumors postoperative radiotherapy is recommended.
背景/目的：基底细胞癌（BCC）是头部最常见的恶性皮肤肿瘤之一，90%的病例发生于此，其特点是局部浸润潜力高且呈破坏性生长。本研究的目的是揭示基底细胞癌的病理组织学类型与该病变大小、基底细胞癌的侵袭性和浸润之间的相关性特征，及其对治疗过程的影响。
我们分析了27例因BCC累及头皮和骨骼而接受手术的患者。我们描述并考量了临床特征（大小、浸润深度）、颅内扩散的持续时间和速度，然后与BCC的类型进行比较。我们描述了手术治疗的范围和切除宽度，以确定最佳治疗方案。患者在接下来的三年里接受了检查。
根据组织病理学类型，最常见的肿瘤为：浸润性（60.2%）、结节浸润性（37.2%）和硬斑病样（2.6%）。肿瘤临床表现为溃疡性病变、侵蚀性溃疡和穿凿性溃疡。肿瘤直径范围为2至25厘米。颅内扩散深度取决于组织学类型和肿瘤大小。大多数复发（35%）发生在硬斑病样BCC类型中。17例病例中，BCC累及骨骼但未发生颅内扩散。10例病例中，基底细胞瘤浸润颅内空间——8例浸润硬脑膜，6例浸润脑实质，其中2例上矢状窦受累，不得不进行手术结扎。
基底细胞癌对脑实质的侵袭性和浸润与组织学类型和肿瘤大小直接相关。基底细胞瘤越大，或者如果组织病理学结果证实为硬斑病样基底细胞瘤，则需要切除更大范围的周围健康组织，有时直径超过3厘米。对于这些肿瘤病例，建议术后进行放疗。
