Basal cell carcinoma in a patient at two rare sites: a case report
DOI:
https://doi.org/10.18203/2320-6012.ijrms20253998Keywords:
Basal cell carcinoma, Morphea form, Non-healing ulcer, Non-sun-exposed, Metastasis, PathologyAbstract
Basal cell carcinoma (BCC) is a locally aggressive cutaneous tumor frequently linked to aberrations in the Hedgehog signaling pathway. It typically occurs on sun-exposed areas; however, rare presentations in non-sun-exposed sites have been documented. A 61‐year‐old female presented with a five-year history of a non-healing ulcer on the right leg. Initially misdiagnosed as Lupus vulgaris, repeated biopsies revealed features consistent with infiltrative BCC and, subsequently, a morpheaform subtype with squamous differentiation. In addition, metastasis was noted in the inguinal region. Radiological studies and histopathological evaluations confirmed the diagnosis. This case underscores that BCC may present at atypical, non-sun-exposed sites and can demonstrate local aggressive behavior with regional metastasis. Early recognition and prompt surgical management are essential to prevent further local invasion and metastasis.
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References
Carr AV, Feller E, Zakka FR, Griffith RC, Schechter S. A Case Report of Basal Cell Carcinoma in a Non-Sun-Exposed Area: A Rare Presentation Mimicking Recurrent Perianal Abscess. Case Rep Surg. 2018;2018:9021289. DOI: https://doi.org/10.1155/2018/9021289
Namratha R, Vijaya B, Reshma R. Histopathological spectrum of cutaneous basal cell carcinoma—An 11-year retrospective study in a tertiary care hospital in southern Karnataka. J Clin Diagn Res. 2021;15(10):EC06-10.
Malhotra P, Singh A, Ramesh V. Basal cell carcinoma in the North Indian population: clinicopathologic review and immunohistochemical analysis. Indian J Dermatol Venereol Leprol. 2011;77(3):328-30. DOI: https://doi.org/10.4103/0378-6323.79710
Manzoor S, Fama S, Anglo R. A rare case of basal cell carcinoma in a non-sun-exposed area: Case report. Int J Contemp Med Res. 2021;8(2):B1–B3.
Bhagchandani L, Sanadi RE, Sattar S, Abbott RR. Basal cell carcinoma presenting as finger mass. A case report. Am J Clin Oncol. 1995;18(2):176-9. DOI: https://doi.org/10.1097/00000421-199504000-00018
Lynch FW, Seidman H, Hammond EC. Incidence of cutaneous cancer in Minnesota. Cancer. 1970;25(1):83-91. DOI: https://doi.org/10.1002/1097-0142(197001)25:1<83::AID-CNCR2820250113>3.0.CO;2-F
Tavares SelegaZo LC. Morpheaform basal cell carcinoma: Case report. ARC J Ophthal. 2017;2(1):9-11.
Gallagher RP, Hill GB, Bajdik CD, Fincham S, Coldman AJ, McLean DI, et al. Sunlight exposure, pigmentary factors, and risk of nonmelanocytic skin cancer. I. Basal cell carcinoma. Arch Dermatol. 1995;131(2):157-63. DOI: https://doi.org/10.1001/archderm.1995.01690140041006
Brenn T, McKee TM. Tumors of the surface epithelium. In: McKee PH, Calonje E, Granter SR, eds. Pathology of the Skin. 3rd ed. Elsevier; 2005:1167-83.
O'Connell KA, Conran RM. Educational Case: Basal Cell Carcinoma. Acad Pathol. 2021;8:2374289521998030. DOI: https://doi.org/10.1177/2374289521998030
Ackerman LV. Rossi and Ackerman’s Surgical Pathology. 11th ed. Philadelphia: Lippincott Williams and Wilkins; 2018: 53.
Beagles C. Rodent ulcer. Trans Pathol Soc. 1894;45:176-7.
Millán-Cayetano JF, Blázquez-Sánchez N, Fernández-Canedo I, Repiso-Jiménez JB, Fúnez-Liébana R, Bautista MD, et al. Metastatic Basal Cell Carcinoma: Case Report and Review of the Literature. Indian J Dermatol. 2020;65(1):61-4. DOI: https://doi.org/10.4103/ijd.IJD_302_18
Bowman PH, Ratz JL, Knoepp TG, Barnes CJ, Finley EM. Basosquamous carcinoma. Dermatol Surg. 2003;29(8):830-2. DOI: https://doi.org/10.1097/00042728-200308000-00013
Robinson JK, Dahiya M. Basal cell carcinoma with pulmonary and lymph node metastasis causing death. Arch Dermatol. 2003;139(5):643-8. DOI: https://doi.org/10.1001/archderm.139.5.643
Wadhera A, Fazio M, Bricca G, Stanton O. Metastatic basal cell carcinoma: a case report and literature review. How accurate is our incidence data? Dermatol Online J. 2006;12(5):7. DOI: https://doi.org/10.5070/D313V4J8VJ
Morgan FC, Ruiz ES, Karia PS, Besaw RJ, Neel VA, Schmults CD. Factors predictive of recurrence, metastasis, and death from primary basal cell carcinoma 2 cm or larger in diameter. J Am Acad Dermatol. 2020;83(3):832-8. DOI: https://doi.org/10.1016/j.jaad.2019.09.075
Baker PB, Berggren R. Metastatic basal cell carcinoma: review and report of a case. Ann Plast Surg. 1983;11(5):428-30. DOI: https://doi.org/10.1097/00000637-198311000-00011
Grace GT, Elias EG. Metastatic basal cell carcinoma. Md Med J. 1991;40(9):799-801.