Department of Pathology, Rush University Medical Center, 1750 W Harrison St, Chicago, IL, 60612, USA.
Arch Dermatol Res. 2021 Aug;313(6):439-443. doi: 10.1007/s00403-020-02120-y. Epub 2020 Aug 10.
Cutaneous basal cell carcinoma is usually an indolent and slow-growing tumor with potential for local invasion and recurrence; however, metastatic events are exceedingly rare. The annual incidence of metastasis is estimated to range between 0.00281 and 0.05%. A retrospective search in the pathology database of a single tertiary institution was performed in the period between 1999 to 2019. Primary cutaneous metastatic basal cell carcinomas had paraffin blocks and glass slides retrieved. A total of 8673 cases was identified. The overall prevalence of metastatic tumors was 0.05% (4/8673). The median patient's age at diagnosis was 61 years old (range 52-79). The most common primary site of tumor was nose (2/4) and the most common histological subtype was infiltrative. The sampled lymph nodes were identified during primary tumor resection, except for 1 patient who had a sentinel lymph node biopsy performed as a surgeon individual decision. One patient had hematogenous spread to the pleura, diagnosed 5 years after diagnosis. In summary, this study adds new data to the current literature in metastatic primary cutaneous basal cell carcinomas and highlights the importance of early diagnosis and appropriate surgical excision in an effort to prevent local advanced disease, recurrence and lymphovascular dissemination.
皮肤基底细胞癌通常是一种惰性和缓慢生长的肿瘤，具有局部侵袭和复发的潜力；然而，转移事件极为罕见。转移的年发生率估计在 0.00281 至 0.05%之间。在 1999 年至 2019 年期间，对一家三级医院的病理学数据库进行了回顾性搜索。检索了有石蜡块和玻璃切片的原发性皮肤转移性基底细胞癌。共确定了 8673 例病例。转移性肿瘤的总患病率为 0.05%（4/8673）。诊断时患者的中位年龄为 61 岁（范围为 52-79 岁）。最常见的肿瘤原发部位是鼻子（2/4），最常见的组织学亚型为浸润性。除了 1 名患者因外科医生的个人决定而进行了前哨淋巴结活检外，其余患者均在原发肿瘤切除时发现了淋巴结。1 名患者发生血行播散至胸膜，在诊断后 5 年被诊断。总之，本研究为转移性原发性皮肤基底细胞癌的现有文献增添了新数据，并强调了早期诊断和适当的手术切除的重要性，以防止局部晚期疾病、复发和淋巴管扩散。
