Novel Insights for Patients with Multiple Basal Cell Carcinomas and Tumors at High-Risk for Recurrence: Risk Factors, Clinical Morphology, and Dermatoscopy

Introduction: Basal cell carcinoma (BCC) quite frequently presents as multiple tumors in individual patients. Neoplasm’s risk factors for local recurrence have a critical impact on therapeutic management. Objective: To detect risk factors for multiple BCCs (mBCC) in individual patients and to describe clinical and dermatoscopic features of low- and high-risk tumors. Materials & Methods: Our study included 225 patients with 304 surgically excised primary BCCs. All patients’ medical history and demographics were recorded. Clinical and dermatoscopic images of BCCs were evaluated for predefined criteria and statistical analyses were performed. Results: Grade II-III sunburns before adulthood (OR 2.146, p = 0.031) and a personal history of BCC (OR 3.403, p < 0.001) were the major predisposing factors for mBCC. Clinically obvious white color (OR 3.168, p < 0.001) and dermatoscopic detection of white shiny lines (OR 2.085, p = 0.025) represented strongly prognostic variables of high-risk BCC. Similarly, extensive clinico-dermatoscopic ulceration (up to 9.2-fold) and nodular morphology (3.6-fold) raise the possibility for high-risk BCC. On the contrary, dermatoscopic evidence of blue-black coloration had a negative prognostic value for high-risk neoplasms (light OR 0.269, p < 0.001/partial OR 0.198, p = 0.001). Conclusions: Profiling of mBCC patients and a thorough knowledge of high-risk tumors’ clinico-dermatoscopic morphology could provide physicians with important information towards prevention of this neoplasm.

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Undifferentiated pleomorphic sarcoma in oropharyngeal mucosa of patients with multiple basal cell carcinomas

Rare Tumors ◽

10.1177/20363613211026483 ◽

2021 ◽

Vol 13 ◽

pp. 203636132110264

Author(s):

Andrea Dekanić ◽

Marko Velepič ◽

Margita Belušić Gobić ◽

Ita Hadžisejdić ◽

Nives Jonjić

Keyword(s):

Differential Diagnosis ◽

Basal Cell ◽

Polypoid Lesion ◽

Older Patient ◽

Mesenchymal Tumors ◽

Undifferentiated Pleomorphic Sarcoma ◽

Pleomorphic Sarcoma ◽

Basal Cell Carcinomas ◽

History Of ◽

Multiple Basal Cell Carcinomas

Malignant mesenchymal tumors of oropharyngeal mucosa are rare. Those with fibroblastic and histiocytic differentiation in the skin are called atypical fibroxanthoma (AFX) and in the soft tissue undifferentiated pleomorphic sarcoma (UPS). Here we present a case of an older patient with a history of multiple basal cell carcinomas and recently with a rapidly growing polypoid lesion in the mucosa of posterior oropharyngeal wall with AFX/UPS morphology. The differential diagnosis, histological pitfalls of this poorly characterized mesenchymal lesions, and the challenges associated with treatment are discussed.

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Comparison of risk factors of single basal cell carcinoma with multiple basal cell carcinomas

Indian Journal of Dermatology ◽

10.4103/0019-5154.84766 ◽

2011 ◽

Vol 56 (4) ◽

pp. 398 ◽

Cited By ~ 6

Author(s):

Hoda Rahimi ◽

Zahra Hallaji ◽

Mostafa Mirshams Shahshahani

Keyword(s):

Risk Factors ◽

Basal Cell Carcinoma ◽

Cell Carcinoma ◽

Basal Cell ◽

Basal Cell Carcinomas ◽

Multiple Basal Cell Carcinomas

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Everolimus for Compassionate Use in Multiple Basal Cell Carcinomas

Case Reports in Dermatological Medicine ◽

10.1155/2013/604301 ◽

2013 ◽

Vol 2013 ◽

pp. 1-4 ◽

Cited By ~ 2

Author(s):

Laura Eibenschutz ◽

Delia Colombo ◽

Caterina Catricalà

Keyword(s):

Basal Cell ◽

Transplant Rejection ◽

Mammalian Target Of Rapamycin ◽

Organ Transplant ◽

Immunosuppressive Agent ◽

Current Treatment ◽

Dose Finding ◽

Basal Cell Carcinomas ◽

History Of ◽

Multiple Basal Cell Carcinomas

Everolimus is an inhibitor of the mammalian target of rapamycin (mTOR) and has been shown to have antineoplastic activity in addition to its use as an immunosuppressive agent for the prevention of organ transplant rejection. We report the use of everolimus for the compassionate treatment of four elderly, nontransplant patients presenting with multiple basal cell carcinomas (BCC). All patients had a long history of BCC, had refused surgery as a current treatment option, and did not respond to alternative treatments (including topical 5-fluorouracil and imiquimod). Patients were treated with oral everolimus (1.5–3.0 mg daily) for 12 months or longer: a complete and sustained response was seen in one case, and partial responses were seen in two other cases. Everolimus was well tolerated in these elderly patients. These promising preliminary data suggest that further dose-finding, controlled clinical studies are warranted to evaluate the antineoplastic effects of everolimus in patients affected by BCC who cannot or will not undergo surgery.

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Multiple Basal Cell Carcinomas Arising in a Port-Wine Stain with a Remote History of Therapeutic Irradiation

The Journal of Dermatology ◽

10.1111/j.1346-8138.2004.tb00607.x ◽

2004 ◽

Vol 31 (10) ◽

pp. 820-823 ◽

Cited By ~ 6

Author(s):

Byung-Soo Kim ◽

Jae-Bong Lee ◽

Ho-Sun Jang ◽

Yoo-Wook Kwon ◽

Kyung-Sool Kwon ◽

...

Keyword(s):

Basal Cell ◽

Port Wine Stain ◽

Port Wine ◽

Basal Cell Carcinomas ◽

History Of ◽

Multiple Basal Cell Carcinomas ◽

Therapeutic Irradiation

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Risk Factors for Single and Multiple Basal Cell Carcinomas

Archives of Dermatology ◽

10.1001/archdermatol.2010.155 ◽

2010 ◽

Vol 146 (8) ◽

Cited By ~ 45

Author(s):

Ville Kiiski ◽

Esther de Vries ◽

Sophie C. Flohil ◽

Monique J. Bijl ◽

Albert Hofman ◽

...

Keyword(s):

Risk Factors ◽

Basal Cell ◽

Basal Cell Carcinomas ◽

Multiple Basal Cell Carcinomas

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Late Onset of Multiple Basal Cell Carcinomas in a Patient with Gorlin-Goltz Syndrome Previously Treated for Hodgkin’s Lymphoma/ Kasna pojava multiplog bazocelularnog karcinoma kod pacijenta sa Gorlin-Golcovim sindromom prethodno lečenog od Hočkinovog limfoma

Serbian Journal of Dermatology and Venerology ◽

10.2478/sjdv-2014-0002 ◽

2014 ◽

Vol 6 (1) ◽

pp. 19-28

Author(s):

Rumyana Yankova ◽

Magdalina Gyurova ◽

Donka Brambarova

Keyword(s):

Basal Cell ◽

Hodgkin’S Lymphoma ◽

Late Onset ◽

Hodgkin's Lymphoma ◽

Goltz Syndrome ◽

Basal Cell Carcinomas ◽

Therapeutic Results ◽

History Of ◽

Multiple Basal Cell Carcinomas

Abstract Development of multiple basal cell carcinomas is commonly associated with immunosuppression or genetic disorders. The latter include congenital diseases such as Gorlin-Goltz syndrome, also known as nevoid basal cell carcinoma syndrome, or basal cell nevus syndrome. It is an autosomal dominant inherited disorder characterized by the development of multiple basal cell carcinomas at an early age and a variable combination of other phenotypic abnormalities that result in multiple organ involvement. The susceptibility gene was mapped to chromosome 9q22.3-3.1. Like other tumor suppressor genes, PTCH1 gene shows frequent deletion and a whole variety of other mutations. A high rate of new mutations and the variable expressivity of the condition make full diagnostic assessment difficult, especially in mildly affected individuals with no family history of the condition. It has been postulated that the presence of two major features or one major feature with two minor features classify a condition as Gorlin-Goltz syndrome. We present a 42-year-old male patient with a 6-year-long history of multiple smooth and/or rough skin patches and plaques on the back and shoulders. Some of the lesions gradually progressed and increased in number without any sensation. Dotlike, flesh-colored and brownish pits were found on the patient’s palms. Further investigations revealed many musculoskeletal and craniofacial congenital abnormalities such as pectus excavatum, frontal and parietal bossing, exotropia, ectopic teeth (impacted tooth), mandibular hyperplasia, broad nose. Histopathological examination by light microscopy of biopsies taken from the nodular and patchy skin lesions showed findings typical for basal cell carcinoma. Family history revealed no members with similar health disorders. The patient was treated for Hodgkin’s lymphoma with chemotherapy and radiation therapy 20 years before, with good therapeutic results, and no additional treatment was administered in the last ten years. The treatment for multiple basal cell carcinomas included: 5% imiquimod cream, 5 days a week, for 12 weeks. After 12 weeks of treatment, the nodular lesion and all the superficial lesions cleared. One month later the lesions disappeared completely without any residual signs. The patient was advised to use adequate photoprotection and to avoid future uncontrolled sun exposure. On follow-up visits during a three year period, no recurrent or new lesions indicative for BCC were seen. This is a case with late-onset multiple BCC in a patient with Gorlin-Goltz syndrome and a history of prior Hodgkin’s lymphoma. To the best of our knowledge hitherto only two cases of Hodgkin’s lymphoma in patients with Gorlin-Goltz syndrome have been reported in the literature. We also present therapeutic results of topical imiquimod for multiple basal cell carcinomas with no recurrent lesions over a three-year follow-up.

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