Chemotherapy for metastatic basal cell carcinoma.

Metastatic basal cell carcinoma is a rare, malignant neoplasm associated with poor survival. A 63-year-old woman had an extensive primary keratinizing basal cell carcinoma of the scalp, with metastases to the regional lymph nodes of the neck. Disease in the primary site and in the regional lymph nodes was controlled by surgery and irradiation. However, skeletal metastases that responded to therapy with three courses of cisplatin and bleomycin sulfate and then to ten courses of cyclophosphamide, methotrexate, and fluorouracil developed. Subsequent progressive metastases failed to respond to a combined cisplatin and cyclophosphamide regimen as well as to etoposide and doxorubicin hydrochloride used as single agents.