Basal cell carcinoma: Difference between revisions

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Latest revision as of 08:11, 14 August 2024

Epidemiology
- Technically the most common cancer, but it is often excluded from data due to its low mortality and morbidity
- BCC accounts for 75% of all skin cancer
- Most common skin cancer
Pathology
- Hedgehog pathway is often mutated
- Almost never metastasises, leading to low mortality and morbidity
- May cause local destruction, which may be severe if located on the face
- Types
  - Nodular BCC
  - Superficial BCC
  - Morpheaform BCC
  - Naevoid basal cell carcinoma syndrome
    - Autosomal dominant disease
    - Multiple BCC in young age
    - Bone and neurological malformations
  - +++
Risk factors
- Chronic sun exposure
- Old age
- Skin types I and II
Clinical features
- Pearly papule or nodule
- Rolled border
- Central crater of ulceration
- On sun-exposed skin
  - Usually upper lip/nose area
- Slow growing
Types
- Nodular BCC
  - Most common type
- Superficial BCC
  - On trunk
  - Flat plaque lesion
- Nevoid basal cell carcinoma syndrome
Prognosis
- Virtually never metastasizes
- Locally aggressive
Diagnosis
- Clinical, based on typical symptoms
- Definite (histological) diagnoses often made after surgical excision of suspected lesion
- Full-thickness biopsy -> histology
Treatment
- Surgery
  - Surgical excision with 5 mm safety border
  - Primary treatment is almost all cases
- Radiotherapy
  - If surgery is not an option
- Chemotherapy
  - Only topical (5-FU)
- Alternatives for superficial and small BCCs
  - Cryosurgery
  - Photodynamic therapy
  - Laser ablation
  - Topical chemotherapy
  - Topical imiquimod
- Targeted therapy
  - Vismodegib or sonidegib
    - Hedgehog pathway inhibitors
  - For metastatic BCC or BCC which recurs after surgery
Follow-up
- Physical examination at 3, 6, 12 months
- Sun protection

@@ Line 1: / Line 1: @@
-<section begin="dermatology" />
+<section begin="dermatology" /><section begin="oncology" />
-* Most common skin cancer
+* Epidemiology
-* Related to mutations in the hedgehog pathway
+** Technically the most common cancer, but it is often excluded from data due to its low mortality and morbidity
+** BCC accounts for 75% of all skin cancer
+** Most common skin cancer
+* Pathology
+** Hedgehog pathway is often mutated
+** Almost never metastasises, leading to low mortality and morbidity
+** May cause local destruction, which may be severe if located on the face
+** Types
+*** Nodular BCC
+*** Superficial BCC
+*** Morpheaform BCC
+*** Naevoid basal cell carcinoma syndrome
+**** Autosomal dominant disease
+**** Multiple BCC in young age
+**** Bone and neurological malformations
+*** +++
 * Risk factors
 ** Chronic sun exposure
@@ Line 24: / Line 39: @@
 ** Locally aggressive
 * Diagnosis
+** Clinical, based on typical symptoms
+** Definite (histological) diagnoses often made after surgical excision of suspected lesion
 ** Full-thickness biopsy -> histology
 * Treatment
-** Surgical excision
+** Surgery
-** Irradiation
+*** Surgical excision with 5 mm safety border
-** Mohs micrographic surgery
+*** Primary treatment is almost all cases
-** Hedgehog pathway inhibitors
+** Radiotherapy
-** For low-risk, spf BCC
+*** If surgery is not an option
+** Chemotherapy
+*** Only topical (5-FU)
+** Alternatives for superficial and small BCCs
+*** Cryosurgery
 *** Photodynamic therapy
-*** Cryotherapy
+*** Laser ablation
-*** 5-FU
+*** Topical chemotherapy
-*** Imiquimod cream
+*** Topical imiquimod
+** Targeted therapy
+*** Vismodegib or sonidegib
+**** Hedgehog pathway inhibitors
+*** For metastatic BCC or BCC which recurs after surgery
 * Follow-up
 ** Physical examination at 3, 6, 12 months
 ** Sun protection
-<section end="dermatology" />
+<section end="dermatology" /><section end="oncology" />
 [[Category:Dermatology]]