Hasan Abdulkarim, Rabie Ahmed, Elhussiny Mohammed, Nasr Mohamed, Kamel Mohamed I, Hegab Ahmed, El-Kady Abdelrahman S, Nagaty Mahmoud E, Seleem Abdelhafez, Abbas Mohammed, Elias Abd Al-Kareem, Shemy Gamal G, Abu Elsoud Ahmed, Dahy Asmaa A, Abdulmohaymen Ayman, Youssef Ahmed, Abdelmaksoud Ayman
Pathology Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Pathology Department, Damietta Faculty of Medicine, Al-Azhar University, Damietta, Egypt.
Ann Med Surg (Lond). 2022 May 26;78:103877. doi: 10.1016/j.amsu.2022.103877. eCollection 2022 Jun.
Recurrence of basal cell carcinoma (BCC) after complete surgical excision is rarely reported. Risk factors for this negative outcome are not well-studied. We present the clinical and histological features of recurrent BCCs in our institution.
All patients between January 2016 to December 2020 whose primary BCCs were excised with free surgical margins according to the histopathology report, and represented later with local recurrence were included. The medical files were retrieved to record patient's age, sex, sun exposure, tumor site, size, clinical diagnosis, histopathology variant of primary lesion, least free margin distance of the original lesion, and recurrence time.
Eighteen patients (11 males and 7 females ranged between 50 and 75 years old) fulfilled the inclusion criteria; all of their lesions were located in head and neck regions. The mean recurrence time was 31.2 months (11-86) and the histological variant was the same of primary in 17/18 patients. Primary tumors showed nodular subtype in 77.8% of patients and 55.6% of the primary tumors were less than 15 mm in diameter. Sun exposure history was given by 77.8% of patients while the rest of patients had non-significant exposure. All recurrent excised lesions were of free margin less than 4 mm.
We found that the primary tumors of all studied recurrent BCCs were excised with surgical margins less than 4 mm. We recommend follow up for all excised BCCs either those of low or high risk histological variants. Tumor size does not appear a considerable risk factor for local recurrence.
基底细胞癌（BCC）在完全手术切除后复发的情况鲜有报道。对于这种不良结局的危险因素尚未进行充分研究。我们展示了我院复发性基底细胞癌的临床和组织学特征。
纳入2016年1月至2020年12月期间所有原发性基底细胞癌根据组织病理学报告以手术切缘阴性切除、随后出现局部复发的患者。检索病历以记录患者的年龄、性别、日晒情况、肿瘤部位、大小、临床诊断、原发性病变的组织病理学变体、原病变的最小切缘距离以及复发时间。
18例患者（11例男性和7例女性，年龄在50至75岁之间）符合纳入标准；所有病变均位于头颈部区域。平均复发时间为31.2个月（11 - 86个月），17/18例患者的组织学变体与原发性相同。77.8%的患者原发性肿瘤表现为结节亚型，55.6%的原发性肿瘤直径小于15毫米。77.8%的患者有日晒史，其余患者日晒情况不显著。所有复发性切除病变的切缘均小于4毫米。
我们发现，所有研究的复发性基底细胞癌的原发性肿瘤切除时切缘均小于4毫米。我们建议对所有切除的基底细胞癌进行随访，无论其组织学变体是低风险还是高风险。肿瘤大小似乎不是局部复发的重要危险因素。
