Basal Cell Carcinoma

Excerpt

Basal cell carcinoma (BCC), previously known as basal cell epithelioma, is humans' most common type of skin cancer. This carcinoma typically arises on sun-exposed skin and rarely develops on the mucous membranes, palms, or soles of the feet. BCC is usually a slow-growing tumor with rare metastases, but delayed or inadequate treatment can result in significant local tissue destruction and disfigurement. Clinically, BCC often appears as pink or flesh-colored, pearly papules with overlying ulceration or telangiectatic vessels. Most cases occur on the head or neck, but can also involve the trunk and extremities.

The literature describes more than 26 histologic subtypes of BCC. The most common and clinically distinctive types include nodular, micronodular, superficial, morpheaform, infiltrative, and fibroepithelial (also known as fibroepithelioma of Pinkus). Combinations of these types can also occur. While most BCCs are amelanotic, some may contain variable amounts of melanin. The primary treatment for BCC is surgical, including standard excision, electrodesiccation and curettage (EDC), cryosurgery, and Mohs micrographic surgery. These approaches are generally reserved for localized disease and achieve excellent outcomes, with 5-year cure rates exceeding 95%.