Snow S N, Sahl W, Lo J S, Mohs F E, Warner T, Dekkinga J A, Feyzi J
Department of Human Oncology, University of Wisconsin Medical School, Madison.
Cancer. 1994 Jan 15;73(2):328-35. doi: 10.1002/1097-0142(19940115)73:2<328::aid-cncr2820730216>3.0.co;2-u.
Metastatic basal cell carcinoma (MBCC) is rare. Risk factors for the development of MBCC include a history of persistent basal cell carcinoma (BCC) for many years, refractory to conventional methods of treatment and previous radiation treatment either in early adulthood or for localized cancer. Most MBCC originate from large tumors.
The authors report five patients with basal cell carcinomas (BCC) of the ear (two patients), scalp, inner canthus, and nasolabial fold that metastasized to the regional lymph nodes, skin, and submandibular gland. In addition, the authors reviewed more than 40 reports of MBCC (n = 65) from 1981 to 1991 and tabulated the primary tumors by size and depth of invasion according to TNM classification, a classification that previously has not been used for BCC.
The authors tabulated the size distribution of tumors of 45 patients with MBCC. The overall mean and median diameters of the primary BCC were 8.7 and 7.0 cm, respectively. The mean area of the primary MBCC lesion that originated on the face and trunk was 62 and 217 cm2, respectively. Using the TNM classification, approximately 9% of MBCC originate from tumors smaller than 10 cm2. In addition, the authors found that large (T2 and T3) and deep (T4) BCC account for approximately 75% of the metastatic tumors. Metastatic BCC from primary tumors smaller than 1 cm in diameter are exceptionally rare.
Approximately 67% of MBCC (n = 238) originate from facial sites. Using the data base of the Mohs Surgery Clinic, the authors found that BCC greater than 3 cm in diameter have approximately a 1.9% incidence of metastasis, and the overall rate of metastases for morpheaform BCC is less than 1%. Patients with tumors classified as T3 and T4 lesions ideally should be followed up for 10 or more years for the remote possibility of the development of MBCC.
转移性基底细胞癌（MBCC）较为罕见。MBCC发生的危险因素包括多年持续性基底细胞癌（BCC）病史、对传统治疗方法难治以及成年早期或局部癌症曾接受过放射治疗。大多数MBCC起源于大肿瘤。
作者报告了5例耳部（2例）、头皮、内眦和鼻唇沟基底细胞癌（BCC）转移至区域淋巴结、皮肤和下颌下腺的患者。此外，作者回顾了1981年至1991年40多篇MBCC报告（n = 65），并根据TNM分类法（一种此前未用于BCC的分类法）按原发肿瘤大小和浸润深度制成表格。
作者列出了45例MBCC患者肿瘤的大小分布情况。原发性BCC的总体平均直径和中位数直径分别为8.7 cm和7.0 cm。起源于面部和躯干的原发性MBCC病变平均面积分别为62 cm²和217 cm²。采用TNM分类法，约9%的MBCC起源于面积小于10 cm²的肿瘤。此外，作者发现大（T2和T3）且深（T4）的BCC约占转移性肿瘤的75%。直径小于1 cm的原发性肿瘤发生转移性BCC极为罕见。
约67%的MBCC（n = 238）起源于面部。利用莫氏外科诊所的数据库，作者发现直径大于3 cm的BCC转移发生率约为1.9%，而硬斑病样BCC的总体转移率小于1%。理想情况下，被分类为T3和T4病变的肿瘤患者应随访10年或更长时间，以监测发生MBCC的远期可能性。
