Pulmonary metastases from basal-cell carcinoma of skin.

Although rodent ulcers are a relatively common malignant condition of the skin, pulmonary metastases arising from them are extremely rare. There have so far been only 29 authenticated reports of this condition. A further case is described of a man who, at the age of 35, developed a rodent ulcer (typical basal-cell carcinoma) on the forehead. Despite local excisions, skin grafting, and radiotherapy, the ulcer continued to recur, although there was no spread to regional lymph nodes. When he was aged 52, he developed widespread bilateral pulmonary lesions and a right pleural effusion. Thoracotomy provided a lung biopsy which showed the typical histological appearance of basal-cell carcinoma. He died aged 54, 19 years after the onset of the rodent ulcer, and necropsy confirmed that the pulmonary lesions were bloodborne metastases of basal-cell carcinoma.