West Lindsey, Fathi Ramin, Nijhawan Rajiv, Srivastava Divya
Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Phoenix Surgical Dermatology Group, Phoenix, AZ, USA.
SAGE Open Med Case Rep. 2020 Feb 17;8:2050313X19847782. doi: 10.1177/2050313X19847782. eCollection 2020.
Although basal cell carcinoma is the most common malignancy in humans, intravascular basal cell carcinoma is rarely reported in the literature. A 78-year-old male presented for Mohs Micrographic surgery of a 1.5 by 1.5 cm nodular and focally infiltrative basal cell carcinoma on the left parietal scalp. In the fifth stage, intravascular tumor cells were noted, and the patient was still positive in five out of six specimens with a defect measuring 6.5 × 7.0 cm. Mohs surgery was stopped due to concern of widespread disease. A positron emission tomography/computed tomography scan was ordered that demonstrated diffuse prominent activity in the cervical level IIa nodes, right sacrum, right scapula, and the third left rib, concerning for metastatic disease. This case emphasizes the importance of vigilance to examine high-risk basal cell carcinoma pathology for intravascular invasion in addition to perineural invasion, especially in the setting of high risk factors for metastatic basal cell carcinoma.
尽管基底细胞癌是人类最常见的恶性肿瘤，但血管内基底细胞癌在文献中鲜有报道。一名78岁男性因左侧顶叶头皮上一个1.5×1.5厘米的结节性且局部浸润性基底细胞癌接受莫氏显微外科手术。在第五阶段，发现了血管内肿瘤细胞，该患者六个标本中有五个仍呈阳性，缺损大小为6.5×7.0厘米。由于担心疾病广泛扩散，莫氏手术停止。随后进行了正电子发射断层扫描/计算机断层扫描，结果显示在颈部IIa区淋巴结、右骶骨、右肩胛骨和左第三肋骨处有弥漫性明显活性，怀疑有转移性疾病。该病例强调了除检查神经周围浸润外，警惕检查高危基底细胞癌病理中血管内浸润的重要性，尤其是在存在转移性基底细胞癌高危因素的情况下。
