In the previous post, a nonmelanoma cancer, Basal Cell Carcinoma, was introduced; its prevalence, clinical features, and treatment methods were discussed. 

Basal cell carcinoma (BCC) is one of the most common forms of skin cancer. Quite often, patients diagnosed with BCC have more than one primary tumours formed over time.

There a few distinct clinical types of BCC and more than 20 histological growth patterns of BCC identified. 

Nodular BCC, also known as nodulocystic carcinoma,  is the most common type of facial BCC. It appears as a shiny or pearly nodule with a smooth surface. The edges appear as rolled because central depression or ulceration is found in the middle of the lesion. Microcystic, micronodular, and infiltrative types are classified as aggressive subtypes.

Superficial BCC is the most common type diagnosed in younger adults. It is usually found on shoulders and upper trunk. It appears as a slightly scaly, irregular plaque with thin, translucent, and rolled border. Multiple microerosions are observed. 

Morphoeic BCC, also known as morphoeiform or sclerosing BCC, is found in mid-facial sites. It is described as a waxy and scar-like plaque that has distinct borders. It has wide and deep subclinical extension.

Basosquamous carcinoma involves two forms of cancer: basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). It is considered as the most aggressive form of skin cancer in comparison with other BCC forms. 

The complications associated with basal cell carcinoma are classified into three groups: recurrent BCC, advanced BCC, and metastatic BCC. 

After initial treatment, recurrence of BCC may arise. This may be triggered due to incomplete excision or presence of very narrow margins at primary excision. Head and neck are the most vulnerable sites, where recurrent BCC is found. Micronodular, morphoeic, and infiltrative subtypes result in recurrence of BCC.

Advanced BCCs involve large and neglected tumours. These lesions may be a few centimeters in diameter. They may deeply infiltrate tissues below skin’s surface. It is quite challenging or in some cases even impossible, to treat advanced BCCs surgically.

Metastatic BCC is very rare, but can lead to fatal results. The primary tumour is usually large, recurrent, or neglected. It is located on neck and head. Metastatic BCC may form on sites that were exposed to ionizing radiation.

The treatment for BCC is determined based on its type, location, and size as well as patient’s personal factors.  Majority of cases are treated surgically. Regular long-term follow-ups are scheduled in order to check for recurrence and formation of new lesions. 

The most common administrated treatment methods include the following: excision biopsy, Mohs micrographically controlled surgery, superficial skin surgery, and cryotherapy.

Centre for Medical and Surgical Dermatology offers different Basal Cell Carcinoma (BCC)

treatments unique to each patient.

For more information regarding dermato-oncology, visit the following link: