Basal Cell Carcinoma in the Head and Neck Area: Radicality of Tumour Removal Considering its Type

Introduction

Basal cell carcinoma (BCC) is the most common malignancy worldwide, accounting for approximately 80% of nonmelanoma skin cancers [1]. BCC has the highest incidence in Australia (up to 1,000 cases per 100,000 annually), followed by the USA (212–407 per 100,000 annually for females and males, respectively) and Europe (76.21–157 per 100,000 annually, varying by country) [2]. BCC originates in the basal cells of the epidermis and is strongly linked to chronic ultraviolet (UV) radiation exposure, which explains its predominance in sun-exposed areas like the head and neck, accounting for approximately 80% of cases [3–5]. Notably, not only cumulative sun exposure but also intense UV exposure during childhood has been implicated as a key risk factor contributing to the development of BCC in adulthood, underscoring the importance of early photoprotection [6]. The risk is further heightened by factors such as fair skin, immunosuppression, and genetic predispositions [7, 8]. Although BCC rarely metastasizes and is not typically life-threatening, its ability to invade local tissues, the high likelihood of recurrence, and its frequent occurrence in cosmetically and functionally sensitive areas necessitate careful management [10]. The impact on quality of life and the potential for significant morbidity underscore the importance of early detection and appropriate treatment. Diagnosis is primarily clinical, supported by dermoscopic examination, with biopsy performed to confirm the diagnosis in atypical cases or when histopathological evaluation is needed to identify the subtype [10, 11]. While smaller lesions with characteristic clinical and dermoscopic features may not require biopsy prior to treatment, it is essential for larger or ambiguous lesions to ensure accurate subtype determination.
Nodular BCC, which accounts for about 60% of cases, typically presents as pearly papules or nodules with telangiectasia and is often confined locally. Superficial BCC, making up 20% of cases, appears as flat, erythematous, scaly patches with well-defined edges and is more frequently seen on the trunk of younger patients. In contrast, morphoeic or infiltrative subtypes are characterized by scar-like plaques with indistinct borders, posing a higher risk of recurrence due to their aggressive and subclinical spread [12].
The National Comprehensive Cancer Network (NCCN) guidelines provide an essential framework for categorizing BCC into low-risk...


Pełna treść artykułu...