#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Giant cutaneous basal cell carcinoma of the head with intracranial propagation – a case report


Authors: V. Bartoš 1;  K. Adamicová 1,2;  I. Mačuga 3;  D. Pokorný 1;  O. Zacharová 1;  M. Péč 4
Authors‘ workplace: Oddelenie patologickej anatómie FNsP, Žilina 1;  Ústav patologickej anatómie Jesseniovej lekárskej fakulty a UNM, Martin 2;  Neurochirurgické oddelenie FNsP, Žilina 3;  Ústav lekárskej biológie Jesseniovej lekárskej fakulty, Martin 4
Published in: Čes.-slov. Patol., 47, 2011, No. 4, p. 178-182
Category: Original Article

Overview

Basal cell carcinoma (BCC) of the skin is generally characterised by a favourable clinical outcome. The slow and mostly local character of growth helps in its early recognition, thus the vast majority of cases are diagnosed in the early phase of disease. However, in cases of long-term neglect of clinical symptoms, certain cancers may reach huge proportions and may significantly destroy surrounding tissue. BCCs larger than 5 cm are called giant BCCs. The authors of the article present a case report of woman suffering from a giant BCC of the head with a history of 15 years of lasting growth, during which she had refused a medical examination. Finally, she was forced to go into hospital due to episodes of unconsciousness and convulsions. Clinical investigations revealed a huge ulcerating tumour in the fronto-parietal region infiltrating the skull and penetrating into the cranial cavity with compression of the brain. A surgical extirpation of the tumor-affected soft tissue and the calva was performed with plastic reconstruction of dura mater and skin. Microscopic examination of biopsy specimens confirmed a diagnosis of mixed BCC with nodular, infiltrative and metatypical features, which had completely infiltrated calva and dura mater. It was not possible to surgically remove a part of the tumour-affected bones of the left orbita, thus the patient is going to undergo local radiotherapy. This case report emphasizes the fact that BCC, in spite of its usually “benign” biological behaviour, should never be underestimated because it may progress to the advanced stage of the disease, for which treatment is much more difficult with a larger negative impact and a significantly worse prognosis for the patient.

Keywords:
basal cell carcinoma – biological behaviour – intracranial propagation


Sources

1. Crowson AN. Basal cell carcinoma: biology, morphology and clinical implications. Mod Pathol 2006; 19(Suppl 2): S127–S147.

2. Tilli CM, Van Steensen MA, Krekels GA, Neumann HA, Ramaekers FC. Molecular etiology and pathogenesis of basal cell carcinoma. Br J Dermatol 2005; 152(6): 1108–1124.

3. Adamicová K, Fetisovová Ž, Mellová Y, Meluš V, Maarouf Z, Argaláczová S. Hodnotenie bazálnej membrány u morfeaformného (invazívneho) bazaliómu. Čes-slov Derm 2005; 80(2): 76–81.

4. Rončević R, Aleksić V, Stojčić M, Jovanović M, Rončević D. Invasive, aggressive basal cell carcinoma: carcinoma basocellulare terebrans – ulcus terebrans. Eur J Plast Surg 2006; 28(6): 379–384.

5. Naumann IC, Cordes SR. Giant basal cell carcinoma of the forehead with extensive intracranial involvement. Ann Otol Rhinol Laryngol 2007; 116(9): 663–666.

6. Vojáčková N, Schmiedbergerová R, Kinkor Z, Pock L. Metastazující bazocelulární karcinom. Čes-slov Derm 2004; 1: 21–33.

7. Šteiner I, Rothröckel P, Šich J, Špaček J. Metastázující bazaliom v mladém věku. Cesk Patol 1984; 20(4): 246–251.

8. Sakalauskaite M, Vitkus K, Balciunas D, Sirsinaitis S, Rocka S. Invasive giant basal cell carcinoma of the head: case report, reconstruction choice and literature review. Centr Eur J Med 2009; 4(4): 519–526.

9. Bartoš V, Adamicová K, Pec M. Aggressive-growth types of basal cell carcinoma of the skin. Acta Med Mart 2009; 9(3): 24–31.

10. Trapl J, Bednář B. Histopathologie kožních chorob. SZN: Praha; 1957: 363–372.

11. Adamicová K, Fetisovová A, Beseda A, Šipka F, Strmeňová V. Invazívny bazalióm v interpretácii patológa a klinika. Bratisl Lek Listy 1995; 96(3): 148–151.

12. Adamicová K, Fetisovová Ž, Mellová Y, Argalácsová S. Invazívny typ bazocelulárneho karcinómu. Lekářské Listy príloha ZdN 2004; 17: 4–5.

13. Cigna E, Tarallo M, Maruccia M, Sorvillo V, Pollastrini A, Scuderi N. Basal cell carcinoma: 10 years of experience. J Skin Cancer. In press 2011.

14. De Bree E, Laliotis A, Manios A, Tsiftsis DD, Melissas J. Super giant basal cell carcinoma of the abdominal wall: still possible in the 21st century. Int J Dermatol 2010; 49(7): 806–809.

15. Lackey PL, Sargent LA, Wong L, et al. Giant basal cell carcinoma surgical management and reconstructive challenges. Ann Plast Surg 2007; 58(3): 250–254.

16. Kokavec R, Fedeles J. Giant basal cell carcinomas: a result of neglect? Acta Chir Plast 2004; 46(3): 67–69.

17. Archontaki M, Stavrianos SD, Korkolis DP, et al. Giant basal cell carcinoma: clinicopathological analysis of 51 cases and review of the literature. Anticancer Res 2009; 29(7): 2655–2663.

18. Schroeder M, Kestlmeier R, Schlegel J, Trappe AE. Extensive cerebral invasion of a basal cell carcinoma of the scalp. Eur J Surg Oncol 2001; 27(5): 510–511.

19. Mathieu D, Fortin D. Intracranial invasion of a basal cell carcinoma of the scalp. Can J Neurol Sci 2005; 32(4): 546–548.

20. Long SD, Kuhn MJ, Wynstra JH. Intracranial extension of basal cell carcinoma of the scalp. Comput Med Imaging Graph 1993; 17(6): 469–471.

21. Kovarik CL, Stewart D, Barnard JJ. Lethal basal cell carcinoma secondary to cerebral invasion. J Am Acad Dermatol 2005; 52(1): 149–151.

22. Parizel PM, Dirix L, Van den Weyngaert D et al. Deep cerebral invasion by basal cell carcinoma of the scalp. Neuroradiology 1996; 38(6): 575–577.

23. Slávik E, Stojčić M, Skender Gazibara M, Vujotić Lj, Radulović D. Bazaliom s propagací do mostomozečkového koutu asociovaný s ipsilaterálním neurinomem akustiku – kazuistika. Cesk Slov Neurol N 2007; 70/103(2): 207–209.

24. Gormley DE, Hirsch P. Aggressive basal cell carcinoma of the scalp. Arch Dermatol 1978; 114(5): 782–783.

25. Mindikoglu AN, Güzel MZ, Senyuva C, Banbaz C, Aydin Y. Surgical treatment of an extensive basal cell carcinoma of the scalp infiltrating the superior sagittal sinus. Eur J Plast Surg 1995; 18(1): 50–52.

26. Moro F, de Caro R, de Caro G, Ninfo V. Eyelid basal cell carcinoma with intracranial extension. Ophthal Plast Reconstr Surg 1998; 14(1): 50–56.

27. Kaur P, Mulvaney M, Carlson A. Basal cell carcinoma progression correlates with host immune response and stromal alterations: a histological analysis. Am J Dermatopathol 2006; 28(4): 293–307.

28. Widgerow AD, Christofides T. Morpheic basal cell carcinoma: transformation or original pathology? Int Journal Plastic Surg 2006; 2(2): electronic letter.

29. Bartoš V, Pokorný D, Zacharová O et al. Metatypický karcinóm kože: klinicko-patologický rozbor diagnostikovaných prípadov a prehľad literatúry. Derma 2010; 10(4): 3–7.

Labels
Anatomical pathology Forensic medical examiner Toxicology
Topics Journals
Login
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account

#ADS_BOTTOM_SCRIPTS#