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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

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