Atypical Presentation of Metastatic Basal Cell Carcinoma
Atypical Presentation of Metastatic Basal Cell Carcinoma
Basal cell carcinoma is an indolent, slow-growing tumor that rarely metastasizes. Approximately 70% of tumors occur in the head and neck regions. If a basal cell tumor metastasizes, it usually spreads to the regional lymph nodes first, followed by the lungs. We describe a patient with basal cell carcinoma of the right lower extremity with skin metastases. Skin biopsy of one tumor revealed fibroepithelioma of Pinkus, a rare variant of basal cell carcinoma.
Basal cell carcinoma is the most common skin malignancy in the white population, accounting for approximately 75% of all nonmelanoma skin cancers in the United States. Arising in epidermis containing hair follicles, it follows an indolent course, with a rare ability to metastasize due to a dependence on growth factors derived from local stroma. Indeed, the incidence of metastasis is approximately 0.1% in surgical centers; more than 205 cases of metastatic basal cell carcinoma have been documented in the world literature. Risk factors for metastatic basal cell carcinoma include age, immune status, size of primary tumor, and depth of invasion as well as environmental factors such as ultraviolet and ionizing radiation.
We describe a rare case of metastatic basal cell carcinoma presenting on the right foot of a female patient with multiple cutaneous nodules along the right lower extremity to the gluteal region. A literature search has revealed limited information regarding metastatic basal cell carcinoma of the skin; moreover, few cases involve basal cell carcinoma of the lower extremities. In addition, skin biopsy specimens from our patient revealed fibroepithelioma of Pinkus, a variant of basal cell carcinoma.
Basal cell carcinoma is an indolent, slow-growing tumor that rarely metastasizes. Approximately 70% of tumors occur in the head and neck regions. If a basal cell tumor metastasizes, it usually spreads to the regional lymph nodes first, followed by the lungs. We describe a patient with basal cell carcinoma of the right lower extremity with skin metastases. Skin biopsy of one tumor revealed fibroepithelioma of Pinkus, a rare variant of basal cell carcinoma.
Basal cell carcinoma is the most common skin malignancy in the white population, accounting for approximately 75% of all nonmelanoma skin cancers in the United States. Arising in epidermis containing hair follicles, it follows an indolent course, with a rare ability to metastasize due to a dependence on growth factors derived from local stroma. Indeed, the incidence of metastasis is approximately 0.1% in surgical centers; more than 205 cases of metastatic basal cell carcinoma have been documented in the world literature. Risk factors for metastatic basal cell carcinoma include age, immune status, size of primary tumor, and depth of invasion as well as environmental factors such as ultraviolet and ionizing radiation.
We describe a rare case of metastatic basal cell carcinoma presenting on the right foot of a female patient with multiple cutaneous nodules along the right lower extremity to the gluteal region. A literature search has revealed limited information regarding metastatic basal cell carcinoma of the skin; moreover, few cases involve basal cell carcinoma of the lower extremities. In addition, skin biopsy specimens from our patient revealed fibroepithelioma of Pinkus, a variant of basal cell carcinoma.