Metastatic basal cell carcinoma: review, pathogenesis, and report of two cases

Abstract

In 93 reported cases of metastatic basal cell carcinoma (BCC), 76 spread through lymphatics or blood vessels. Two more cases are presented, bringing the total to 78. Metastases to regional lymph nodes were the most frequent, followed in frequency by lungs, bones and other organs. The size of the primary tumor, its site, resistance to X-ray therapy and the effects of radiation appeared to contribute to the occurrence of metastases. In an appreciable number of cases, tumor dissemination was related to incomplete excision followed by immediate wound closure, particularly by grafting. Wound grafting should be delayed for at least 6 mo. after excision of large or recurrent BCC to assure complete removal.