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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The early detection and referral of a small basal cell carcinoma of the face will prevent extensive surgical excision and repair necessary for a neglected lesion. Since these tumors occur in the older population, careful examination of the skin should be performed on patients 50 years of age and older. This cancer has been estimated to constitute 90% of all malignant lid tumors and a suspicious lesion on the lid should be considered a basal cell carcinoma until proven otherwise. The lesion has a very characteristic appearance as described in the text; however, they can present with an atypical picture. An important sign in the evaluation of a possible malignant lid tumor is the loss of eyelashes within or adjacent to the lesion, which indicates the destructive nature of the tumor to the hair follicles. Basal cell carcinomas do not metastasize to distant locations in the body but rather extend locally and can produce deep tissue invasion. Differential diagnosis can present problems to the clinician but the definitive diagnosis is dependent upon the pathologist. The treatment usually requires surgical removal with wide excisional margins; however, other forms of treatment have been attempted. Recurrences of basal cell carcinomas are not uncommon, especially following an initial recurrence and it is mandatory that these patients be re-examined at least every six months for a two year follow-up period.
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PMID:Basal cell carcinoma. A case of longstanding neglect and a case of early detection. 715 51

The complete mastery of reconstructive plastic surgery is a basic requirement essential for sufficient radical treatment of basal cell carcinoma in the facial area. Furthermore, the subclinical growth of the basal cell carcinoma must be taken into consideration. One can assume that the growth of the b.c.c. is much greater than the apparent clinical limits, especially in cases of recurrent tumours, tumours of long standing, tumours in frontal and temporal regions, as well as tumours with diameters of more than 2 cm and scleroderma growth. In such cases a safety margin of 8-15 mm is required, whereas in primary and locally well-defined b.c.c. a safety margin of 3-5 mm is regarded as sufficient. Following the examination of the microscopically controlled surgery developed by Mohs, which is suitable for improvement of the five-year cure rate after surgical treatment of b.c.c., the treatment of the squamous cell carcinoma of the bottom lip is dealt with. Taking into account the tendency of these tumours to metastasize, it is advised to carry out an elective neck-dissection confined to the suprahyoidal region in case of large squamous cell carcinoma and also in suspicious metastatic changes in the lymph nodes. The diagnosis of a malignant melanoma is fundamentally histological: The tumour is electrically excised with a clearance safety margin of surrounding skin of 0.5-1 cm if clinically there appears to be a 10% likelihood of the tumour being a malignant melanoma. If the histological frozen section of the excised tumour confirms the suspected diagnosis, in cases of high-risk melanomas an area of not less than 3 cm from the edge of the primary tumour must be reexcised. A free skin graft is preferred to cover the defect rather than a plastic repair by a pedicle-flap graft. The elective lymph node dissection in the case of malignant melanoma stage I is made dependent on the level of invasion and on the thickness of the tumour. Low-risk melanomas are operated on locally only whereas an elective dissection of the regional lymph nodes is generally recommended in cases of high-risk melanomas.
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PMID:[Oncological principles of the treatment of facial skin cancer]. 717 79

Two cases of basal cell carcinoma of the scrotum are reported. Wide local excision of the lesion is all that is necessary as primary treatment because regional lymph node metastases are seldom seen.
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PMID:Basal cell carcinoma of scrotum. 721 Mar 74

306 patients underwent extensive plastic surgery in the last five years for advanced basal cell carcinoma. In 12 patients either due to delay in presentation or due to inadequate treatment squamous cell carcinoma supervened. In all 12 cases reconstruction was very limited or impossible. Prostheses were used to mask those defects which could not be reconstructed. The infiltrative growth of these squamous cell carcinomas towards the brain could not be controlled. Eventually all the patients developed wide-spread systemic metastases.
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PMID:[Advanced basal cell carcinoma]. 725 13

Six patients with basal cell carcinoma of the vulva underwent differentiated surgical therapy, and their courses were evaluated. No apparent differences in survival time and absence of recurrences and metastases were observed inthe patients treated with radical vulvectomy (1 case), simple vulvectomy (3 cases) and local excision (2 cases). Conservative surgical therapy is therefore considered most indicated.
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PMID:Basal cell carcinoma of the vulva. 733 4

Basal cell carcinoma is a common cutaneous neoplasm that rarely metastasizes. We studied the clinical and pathologic features of 17 patients with metastatic basal cell carcinoma as recorded in the files of the Armed Forces Institute of Pathology (AFIP). Sixteen of the patients were male, and as far as it could be determined, all were white. The most frequent site of metastasis was lung (9 cases), followed by bone (5), lymph nodes (4), liver (3), spleen (1), and adrenal gland (1). Thirteen of the patients had metastatic lesions involving only one organ system. Mean survival time after metastasis was 1.6 years. Features of metatypical (basosquamous) basal cell carcinoma were common in the primary and recurrent tumors, and metastatic lesions generally had a metatypical or adenoid pattern. Two of the five bony metastases demonstrated shadow cells characteristic of pilomatrixoma. The metatypical pattern of a basal cell carcinoma is a feature of an aggressive lesion with the ability to metastasize.
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PMID:Metastatic basal cell carcinoma: a clinicopathologic study of seventeen cases. 739 37

Report of a 85 year old woman with monstrous basal cell carcinoma of 20 years duration. No metastases or osseous destruction were found. Following X-ray therapy the tumor completely disappeared.
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PMID:[Monstrous atypical basaloma]. 745 Nov 59

Basal cell carcinoma (BCC) is the most frequent cutaneous neoplasm, with a generally favorable clinical behavior. Sometimes, indeed, it recurs after therapy and/or metastasizes. As point mutations in the coding sequence of the p53 tumor suppressor gene have been implicated in the progression of many human tumors, we studied the expression of p53 protein on this neoplasia. We tested immunohistochemically the positivity for p53 protein (NCL-p53-CM1, YLEM) on 19 cases of morphologically "non aggressive" BCC (BCC1) and on 19 "aggressive" BCC (BCC2), all with one or more relapses and 3 with distant metastases also. Results were related to clinico-pathological and follow-up data. All but one BCC2 were found positive for p53 protein. Conversely, only 2 cases of BCC1 exhibited low immunoreactivity for p53 protein, with high statistical differences between the two groups. No correlation was found between the immunoreactivity, age of patients, and site of the lesions. The availability of immunohistochemistry and the relatively easy interpretation of the results make screening for p53 protein a possibly useful tool in the prognostic evaluation of BCC.
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PMID:p53 protein in aggressive and non-aggressive basal cell carcinoma. 750 46

Metastatic spread of malignancy is the primary cause of treatment failure and subsequent death in cancer patients. All cancers have the capability to metastasize, however, there are notable exceptions which rarely if ever metastasize. These include basal cell carcinoma, or cancers which are primarily locally invasive such as primary brain cancers. Is metastasis is an earlier process in cancer progression than originally hypothesized? Over 70% of patients have occult or overt metastatic disease at the time of presentation. Thus, the overwhelming proportion of patients have disease which is not surgically resectable for cure at the time of diagnosis. Metastasis is a continuous process commencing early in the growth of the primary tumor before it is clinically detectable by the most sensitive of means. In addition, metastases have the propensity to metastasize. The size and age variation in metastases, their dispersed anatomic locations, the local vascular and lymphatic environment, and their heterogeneous composition hinder complete surgical extirpation of disease and limit the effective concentration of anticancer drugs that can be delivered to metastatic colonies.
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PMID:Development and prevention of metastasis. 751 Sep 40

Metastases are occasionally associated with cutaneous squamous cell carcinoma but only rarely with basal cell carcinoma. There are approximately 200 cases of metastases from basal cell carcinoma reported in the world literature. We describe 6 additional cases. All of our patients demonstrated recurrence at the primary site before they developed their metastases. Metastases presented in subcutaneous tissue, cervical lymph nodes, bone, and lung between 1.5 and 14 years after initial treatment of the primary lesion. The long interval seen in these patients between the initial treatment of the primary and the development of metastases underscores the need for long-term follow-up in what is often thought to be a nonaggressive, nonmetastasizing malignancy.
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PMID:Metastatic basal cell carcinoma of the head and neck. 763 Feb 92


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