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BASAL CELL CARCINOMA
Yono Hadi Agusni
Dept of Dermatovenereology
Padjadjaran University
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Basal cell carcinoma
Sinonim :
- Basal cell epithelioma
- Basalioma
- Ulcus roden / Rodent ulcer
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Basal cell carcinoma
Malignant tumor of the skin that is believed to arise from
the hair follicle
( David J. Leffell & David A. Fitzgerald)
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EPIDEMIOLOGY
US : 146 per 100.000
Australia : 726 per 100.000
Over the past decade, significant increases the incidence oc
BCC have been observed in Europe, Australia and United
States
Indonesia : ?
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Age : over 40 years
Sex : male more than female
Race : rare in black / brown skinned
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Predisposing factors
Agents
Skin Lesions
Syndromes
Settings
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Predisposing agents
Ultraviolet light
Ionizing radiation
Chemical carcinogens
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Predisposing skin lesions
Dermatofibromas
Nevus sebaceous
Burns scars, Chronic ulcers
Linear unilateral basal cell nevus
Stanley J. Miller)
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Predisposing syndromes
Xeroderma pigmentosum
Nevoid basal cell carcinoma syndrome
Bazex syndrome
(Stanley J. Miller)
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Predisposing settings
Immunosuppression
Genetic tendency
Stanley J. Miller
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Physical examination
1)
Distribution : sun-exposed area
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Physical examination 2)
Skin lesions :
Papule or nodule
translucents or pearly
rodent ulcer
(ulcer with a rolled border)
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Physical examination
3)
Color : Pink or red
Brown to Black
Palpation : Hard , firm
Cystic lesion may occur
Shape : Round, oval, depressed centre
(umbilicated)
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Variants :
Noduloulcerative type
Sclerosing type (morphea-like type)
Superficial (multicentric) type
Pigmented type
-William A. Caro
- Thomas B. Fitzpatrick
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Laboratory findings
None
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Pathology anatomy :
Site Epidermis & dermis
Process Proliferating atypical basal cells (large, oval, deep-
blue staining on H&E, but with a little anaplasia and
infrequent mitoses) with variable amounts of stroma.
Thomas B. Fitzpatrick
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Different diagnosis
Squamous cell carcinoma
Keratoacanthoma
Nevus pigmentosus
Chronic ulcer
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Complications :
BCC have a little tendency to metastasize
BCC invade and destroy underlying tissue
destruction of underlying tissue makes BCC
lookslike malignant
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Treatments
Excision
Cryosurgery
Curettage
Electrosurgery
Radiotherapy
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MOHS surgery
Mohs micrographyc surgery is a technique by which skin
cancer are excised with complete, three dimensional
microscopic control of all surgical margins, allowing the
detection and excision of all subclinical tumor extensions.
Nicholas R. Telfler/clinic in dermatol
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Prognosis
In general : oo