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Background:
Basal cell carcinoma (BCC) is the most common type of human cancer. Despite the high prevalence of these tumors, there is a lack of reliable epidemiological data in some regions including Iran.
Objective:
To assess the relationship between BCC subtypes and anatomical distribution in the Iranian population.
Methods:
There were 876 p...
Context in source publication
Context 1
... nodular and superficial, 49 were nodular and micronodular, 29 were nodular and adenoid and others were a combination of various BCC subtypes. Fifty-two percent of the mixed type BCCs were on the face, 37% on scalp, 8% on ear, 2% on neck and the remaining on trunk. Histologic subtypes of BCC within the different ana- tomical sites are outlined in Fig. 2. There was no signi- ficant difference between male and female in BCC subtypes, but anatomical distribution of the tumors was different, in which scalp and ear BCC occurred less common in female than male. More than 65.0% of BCCs in female patients occurred on the face and 21.7% on the scalp, while the percentage in male patients were ...
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Basal cell carcinoma is the most frequent malignant neoplasm in white‐skinned individuals. It develops in different body areas, including in the scalp, which is a unique anatomical region due to the high number of pilosebaceous follicles; the scalp is protected from UV exposure, a main risk factor for basal cell carcinoma development. Moreover, sca...
We report a case of advanced basal cell carcinoma and cranial osteomyelitis. His skull bone seemed to be destroyed due to osteomyelitis, and the underlying dura was exposed with a unique color of the wound surface due to pigment-producing bacteria.
Background: of the world. Rarity of its incidence could be due to protective effects of melanin.Though it is the largest organ by surface area, occurrence of cutaneous malignanc Presentation is usually earlier due to the fact that it is easily noticeable. sex incidence, common site of presentation, type of histology,optimal management and its outco...
Introduction : Recurrence rates for incompletely excised basal cell carcinoma (BCC) vary widely in the literature. Clinical observation is a commonly accepted method of follow up, however such management of these lesions still remains controversial.
Aim : To evaluate the rate and factors associated with the recurrence of BCC of the head and neck r...
Citations
... The incidence of these tumors increases on the scalp, with 2%-18% BCCs and 3%-8% SCCs, respectively. 3,5,6 Notably, both tumors tend to ulcerate when they are present on the scalp. BCCs on the scalp commonly exhibit nodular and pigmented characteristics compared with those elsewhere on the skin. ...
Background
Surgeons face challenges associated with adherent cutaneous scalp malignancy. Traditional general anesthetic excision involves periosteal removal and burring of the outer table of the calvaria for deep margin clarity and tissue reconstruction. Research on this practice is limited, and graft survival in burr-treated bones is underexplored. This study aimed to assess the clinical margin accuracy for immobile scalp malignancies, identify deep-invading malignancy types, and evaluate graft survival in burr-treated calvariae. It compares split-thickness grafts (STSGs) and full-thickness grafts (FTSGs).
Methods
Twelve fixed scalp malignancies were excised under anesthesia, allowing immediate STSG or FTSG for defect reconstruction. Postsurgery, graft take, malignancy type, and margin clearance were evaluated.
Results
Histopathological diagnosis identified seven squamous cell carcinomas, two melanomas, one basal cell carcinoma, one adenocarcinoma, and one metastatic squamous cell carcinoma. Deep margins ranged from 0 to 0.9 mm, and peripheral margins ranged from 0 to 15 mm. The graft take was 100% in eight cases, with total failure in two cases, and 75%–90% in two cases. The five STSGs had 100% take and 90% take. The three FTSGs had 100%, 75%, and two failed.
Conclusions
Clinical examination effectively gauges the tumor fixation depth, but large lesions may require imaging. Most deep-invading tumors were SCCs. STSGs performed better on burr-treated Calvaria than FTSGs.
... We also reviewed other studies where, in contrast to our data, the majority of subjects were male [3,[22][23][24]. Ghanadan et al. (2014) attributed this gender distribution to factors such as women's higher usage of products containing SPF (sun protection factor) for face protection from ultraviolet (UV) rays and men's increased outdoor exposure leading to greater direct UV radiation exposure [25]. The predominant representation of women in our study can be elucidated by the admission process, where patients transition to the Department of Plastic and Reconstructive Surgery from the Department of Dermatology without specific genderbased selection during the study. ...
... We also reviewed other studies where, in contrast to our data, the majority of subjects were male [3,[22][23][24]. Ghanadan et al. (2014) attributed this gender distribution to factors such as women's higher usage of products containing SPF (sun protection factor) for face protection from ultraviolet (UV) rays and men's increased outdoor exposure leading to greater direct UV radiation exposure [25]. The predominant representation of women in our study can be elucidated by the admission process, where patients transition to the Department of Plastic and Reconstructive Surgery from the Department of Dermatology without specific genderbased selection during the study. ...
... The overall recurrence rate was 8.3% [33]. According to the results of our study, the overall recurrence rate of BCC in the nasal area (6.4%) possibly increased because the majority of the study sample consisted of the aggressive and, according to literature sources, more prone to relapse infiltrative BCC morphological subtype [3,9,16,25,26]. ...
In Caucasians, basal cell carcinoma, the predominant non-melanoma skin cancer type, poses challenges for surgeons due to anatomical and aesthetic concerns, particularly when located on the nose. The study aimed to evaluate tumor distribution, size, morphological subtypes, surgical outcomes, radicality levels, and their correlation with recurrence rates. A retrospective analysis encompassed 343 cases of nasal skin cancer over a four-year period from 1 January 2019 to 31 December 2022. The research cohort comprised 252 female and 91 male participants, averaging 75.2 years old. Tumors were most found on the left sidewall of the nose (25.4%) and the dorsum (24.8%). The infiltrative morphological subtype was predominant (70.8%). Standard surgical excision with fasciocutaneous plastic was the preferred surgical procedure. Radical excision, defined by the absence of tumor cells in a resection margin, was accomplished in 79.0% of lesions, whereas 16.9% demonstrated incomplete excision, signifying the presence of tumor cells in the resection margin. Non-radically excised tumors exhibited a significantly higher recurrence rate (24.1%) compared to those with radical excision (6.3%). In nasal reconstruction, diverse surgical techniques are essential for precise adaptation based on factors like tumor characteristics and patient needs. Despite surgeons’ careful adherence to excision margin guidelines, the possibility of non-radical outcome cannot be eliminated.
... This may be a result of the data clustering based on BCC subtypes which exhibit different dermoscopic features. Certain BCC subtypes such as the nodular BCC are more common in the H&N region 16,17 which may explain the observed clustering patterns on the t-SNE plot. However, the HAM10000 dataset does not have information on the BCC subtypes and further studies will be required to investigate this. ...
Background
Management of skin cancers are heavily dependent on clinical diagnosis via dermoscopy. Dermoscopic morphology of basal cell carcinomas (BCC) and melanomas influence diagnosis and may be influenced by anatomic location.
Objective
In this study, we aimed to investigate the morphologic differences between anatomic sites of the head and neck (H&N) versus other body sites in basal cell carcinomas and melanomas.
Patients and methods
The publicly available HAM10000 dataset was used in this study. Morphometric image analysis of the BCCs (n=422) and melanomas (n=868) in this dataset was performed using an open-source image analysis software. Univariate and multivariate statistical analysis was done to identify differences between H&N and other anatomic sites. The multifactorial data was further interrogated with dimensionality reduction techniques, linear discriminant analysis, principal component analysis and t-distributed stochastic neighbour embedding.
Results
Univariate and multivariate statistical analyses revealed significant differences between H&N and other sites for both BCCs and melanomas ( P <0.05). Fifty-three univariate and 11 multivariate features were found to be statistically significant in the BCC group. Thirteen univariate and 8 multivariate features were statistically significant in the melanoma group. Dimensionality reduction via linear discriminant analysis of the BCC groups revealed modest separation of the data by anatomical site. However, melanomas appeared to be more homogenous across H&N and other body sites.
Conclusion
BCCs of the H&N may be morphologically different to BCCs of other body sites. This may influence the accuracy of computer-assisted diagnostic tools and specialist clinicians working predominantly in the H&N region should exercise caution when employing these tools in clinical practice.
... We also reviewed other studies where, in contrast to our data, the majority of subjects were male [3,[22][23][24]. Ghanadan et al. (2014) attributed this gender distribution to factors such as women's higher usage of SPF face protection products and men's increased outdoor exposure leading to greater direct UV radiation exposure [25]. ...
In Caucasians, basal cell carcinoma, a type of non-melanoma skin cancer, is most often found on the nose. This presents challenges for surgeons due to anatomical, functional, and aesthetic concerns. The study aimed to evaluate the distribution of tumor localization, size, morphological subtypes, surgical outcomes, radicality levels, and their correlation with recurrence rates. The research utilized data from the Hygiene Institute Health Information Centre. A retrospective analysis encompassed 343 cases of nasal skin cancer over a four-year period from January 1, 2019, to December 31, 2022. The research cohort comprised 252 female and 91 male participants, averaging 75,2 years old. Tumors were most found on the left sidewall of the nose (25.4%) and the dorsum (24.8%). The infiltrative morphological subtype was predominant (70.8%). Standard surgical excision with fasciocutaneous plastic was the preferred surgical procedure. Radical excision was achieved in 79.0% of lesions, while 16.9% were incompletely excised. Non-radically excised tumors exhibited a significantly higher recurrence rate (24.1%) compared to those with radical excision (6.3%). In nasal reconstruction, diverse surgical techniques are essential for precise adaptation based on factors like tumor characteristics and patient needs. Despite surgeons' careful adherence to excision guidelines, the potential for non-radical procedures cannot be entirely eliminated.
... Certain subtypes tend to appear in certain parts of the body. The most effective and common treatment method is surgical excision [2,7]. For low-risk tumors for which surgery is not considered, other treatment methods are electrodesiccation, cryotherapy, topical immunostimulants such as imiquimod or 5 fluorouracil, and photodynamic therapy [8]. ...
... Ultraviolet rays are the most important risk factor for skin malignancies, involving BCC. It most commonly occurs in the head and neck region [5,7]. ...
... BCC affects older men (>60 years old) and younger women (<40 years old) more [2,7]. This may be because the exposure of men and women to the sun differs according to their type of jobs, clothing, and other regional customs [7]. ...
... This descriptive-analytical study was conducted on the excisional biopsy samples of the head and neck BCC and cSCC, which were obtained from Khatam- Location of tissue specimen were skin of the nose (26.3%), forehead (17.1%), scalp (15.8%), ear (13.2%), neck (11.8%), cheek (9.2%), and eyelids (6.6%). After examining hematoxylin and eosin staining slides and confirming the histopathological diagnosis of the lesions, the BCC samples were categorized according to the instructions of the World Health Organization (18). Histopathologic subtypes of the BCC samples were nodular, sclerosing, basosquamous, superficial, and adenoid patterns. ...
Background: The role of tumor-associated tissue eosinophils and mast cells in the biological behavior of tumors remains unclear. Objectives: This study was performed to compare the eosinophil and mast cell counts in the cutaneous squamous cell carcinoma (cSCC) and basal cell carcinoma (BCC) of the head and neck and to evaluate their relationship with clinicopathologic factors. Methods: The current descriptive-analytical study was conducted on the histopathologic slides of 46 BCC and 30 cSCC samples prepared by using Sirius red and toluidine blue staining techniques for eosinophil and mast cell counts, respectively. The data were analyzed, using Pearson’s correlation, t test, and ANOVA test. Results: The BCC and cSCC samples had mean eosinophil counts of 35.43 ± 35 and 331.27 ± 321.68 eosinophil/10 HPF, respectively, and this difference was statistically significant (P = 0.001). The levels of the mast cell infiltration were obtained as 55.33 ± 39.90 and 63.67 ± 40.86 in BCC and cSCC, respectively. However, this variable was not significantly different between the two groups of BCC and cSCC samples (P = 0.380). In addition, the mean eosinophil and mast cell counts were higher in cSCC grade 3 than in other grades; however, this difference was statistically significant only for the mast cells. Furthermore, the mean eosinophil/mast cell count in cSCC and BCC showed no significant relationship with age and gender. Conclusions: Considering the greater presence of eosinophils in cSCC than in BCC, eosinophils may be concluded to be among the factors responsible for more biologically and clinically invasive behaviors of cSCC, compared to those of BCC.
... Ulcerated (ulcus rodens), destructive (ulcus terebrans), pigmented, and mixed variants may also be observed [1,19]. Nodular is the most frequent subtype, accounting for approximately 50-79% of all BCCs, followed by superficial BCC (15%) [7,20,21]. Nodular subtypes are well-demarcated reddish to skincolored nodules or plaques that can be translucent and have a lowering in the middle [1]. Superficial BCCs appear as scaly erythematous patches or plaques that are also typically well-demarcated, while morpheaformic BCCs present as slightly erythematous or skin-colored, scar-looking lesions with poorly defined margins [1]. ...
Basal cell carcinoma (BCC) is the most common nonmelanoma skin cancer in Switzerland and worldwide. Most BCCs can be treated in a curative setting. However, patients can develop locally destructive and, rarely, metastatic tumors that require a different treatment approach. The clinical subtype of individual lesions provides prognostic information and influences management decisions. Surgical excision, topical therapies, and radiotherapy are highly effective in the majority of subtypes as well as in low- and high-risk diseases. For patients with low-risk diseases and superficial tumors not amenable to surgery, several nonsurgical alternatives are available. Systemic therapy is indicated for high-risk BCCs, which are not amenable to either surgery or radiotherapy. Hedgehog pathway inhibitors (HHI) are currently approved. Other therapeutic options such as immune checkpoint inhibitors show promising results in clinical trials. This first version of Swiss recommendations for diagnosis and management of BCC was prepared through extensive literature review and an advisory board consensus of expert dermatologists and oncologists in Switzerland. The present guidelines recommend therapies based on a multidisciplinary team approach and rate of recurrence for individual lesions. Based on the risk of recurrence, two distinct groups have been identified: low-risk (easy-to-treat) and high-risk (difficult-to-treat) tumors. Based on these classifications, evidence-based recommendations of available therapies are presented herein.
... Studi epidemiologi menunjukan peningkatan insiden KSB sekitar 3-10% pertahun di seluruh dunia terutama pada kulit putih. 1 Tumor kulit ini dapat dijumpai pada semua usia tetapi insiden meningkat terutama setelah usia 50 tahun. Mayoritas pasien adalah laki-laki, perbandingan 1,5-2 : 1. 2 Banyak hal yang dapat mencetuskan KSB dan faktor risiko terbesar adalah paparan sinar UV, terutama UVB (290-320 nm) yang dapat menginduksi mutasi gen supresor tumor. 1,3 Hal ini menjelaskan kenapa penyakit ini sering timbul pada area yang sering terpapar sinar matahari, seperti misalnya kepala dan leher. ...
Introduction: Basal cell carcinoma (BCC) is a malignant neoplasm originating from non-keratinized cells. The incidence increases worldwide and one of the triggering factors is excessive exposure to ultraviolet (UV) rays. The therapy aims to eradicate the tumor and maintain optimal organ function and cosmetic results after the procedure, one of which is the excision technique accompanied by an island pedicle flap. Case Description: A man, 67 years old, came with a complaint of a black lump on the left cheek accompanied by a wound that did not heal. Based on the history, physical examination, and investigations, the patient was diagnosed with mixed type BCC. Excision and wound closure were performed with the island pedicle flap technique. Conclusion: The treatment chosen in this case is surgical excision and island pedicle flap. Although the wound healing is classified as good, the prognosis of the patient is dubius. Considering the location of the lesion and the histopathological results showing an aggressive tumor with a tendency to metastasize, the patient is advised to take precautions. Pendahuluan: Karsinoma sel basal (KSB) adalah neoplasma ganas yang berasal dari sel non keratin. Terjadi peningkatan insiden KSB di seluruh dunia dan salah satu faktor pencetusnya adalah paparan sinar ultraviolet (UV) berlebih. Terapi yang dilakukan bertujuan untuk mengeradikasi tumor serta tetap mempertahankan fungsi organ dan hasil kosmetik yang optimal paska tindakan, salah satunya dalah dengan teknik eksisi yang disertai island pedicle flap. Deskripsi kasus: Seorang laki-laki, usia 67 tahun, datang dengan keluhan benjolan kehitaman pada pipi kiri yang disertai luka yang tidak kunjung sembuh di atas benjolan. Berdasarkan anamnesis, pemeriksaan fisik dan penunjang, pasien terdiagnosis KSB tipe campuran. Dilakukan tindakan eksisi dan penutupan luka dengan teknik island pedicle flap. Simpulan: Tatalaksana yang dipilih pada kasus ini adalah pembedahan eksisi serta island pedicle flap. Meskipun penyembuhan luka tergolong baik, namun prognosis pasien dubius. Mengingat lokasi lesi dan hasil histopatologi yang menunjukkan tumor agresif yang memiliki kecenderungan metastase, pasien disarankan untuk melakukan pencegahan.
... This frequency of tumour types is fairly consistent within the existing literature, with nodular and superficial BCC being predominant across nearly all studies, with rates ranging from 39.5% to 78.7% for nodular and 3%-43% for superficial, dependent on the patient cohort in question. [20][21][22] It has been suggested that rates of superficial BCC may be under reported due to the tendency for these lesions to be treated with topical treatment as opposed to surgical intervention with formal histopathology. 15 Furthermore, rates of highrisk tumour types (i.e., infiltrative, micronodular, morpheaform) are often difficult to determine as much of the literature combines them together in order to simplify classification. ...
Background:
Basal cell carcinoma (BCC) is one of the most common malignancies in the world. The frequency of histopathological subtypes and the distribution on the body of BCC has been well documented. Less has been written on the nature of secondary tumours. The genetics of BCC is starting to be understood, particularly with the advent of newer medical treatments (hedgehog inhibitors).
Objectives:
To determine if primary basal cell carcinoma histopathological subtype predicts secondary tumour subtype, as well as their anatomical distribution.
Methods:
A retrospective case series of patients over the age of 18 was performed from 2009 to 2014, with at least two separate diagnoses of BCC.
Results:
In 394 identified patients, a total of 1355 BCCs arose in the cohort over the 6-year study period. The number of secondary BCCs per patient ranged from 2 to 19 tumours. Nodular BCC was the most likely to reoccur in secondary tumours (53.3%), followed by mixed subtypes (45.7%).
Conclusions:
Within our study, we did find a predisposition for secondary BCCs to be of the same histopathological subtype as the primary, particularly with respect to nodular and mixed tumours. Furthermore, we found that secondary tumours were also more likely to occur on the same anatomical site as the primary tumour. We are only just beginning to under the genetic mutations involved in subtype formation.
... Tumours were detected in skin tissue excised from various anatomical locations such as noses, temples, cheeks and eyelids. While only ∼15% of BCCs are infiltrative [25,26], the ability to detect such small BCCs is important as they often penetrate into the deeper layers of skin, making it difficult for surgeons to identify them on the excision margins (Fig. 5(c)). ...
We present the first clinical integration of a prototype device based on integrated auto-fluorescence imaging and Raman spectroscopy (Fast Raman device) for intra-operative assessment of surgical margins during Mohs micrographic surgery of basal cell carcinoma (BCC). Fresh skin specimens from 112 patients were used to optimise the tissue pre-processing and the Fast Raman algorithms to enable an analysis of complete Mohs layers within 30 minutes. The optimisation allowed >95% of the resection surface area to be investigated (including the deep and epidermal margins). The Fast Raman device was then used to analyse skin layers excised from the most relevant anatomical sites (nose, temple, eyelid, cheek, forehead, eyebrow and lip) and to detect the three main types of BCC (nodular, superficial and infiltrative). These results suggest that the Fast Raman technique is a promising tool to provide an objective diagnosis “tumour clear yes/no” during Mohs surgery of BCC. This clinical integration study is a key step towards a larger scale diagnosis test accuracy study to reliably determine the sensitivity and specificity in a clinical setting.
