Pulmonary metastasis of basal cell carcinoma

• Published in: The American surgeon 2013-06, Vol.79 (6), p.E221-222
• Main Authors: Black, Emily A, Duncan, Lisa D, Dieter, 3rd, Raymond A
• Format: Article
• Language: English
• Subjects: Carcinoma, Basal Cell - secondary; Family medical history; Humans; Lung Neoplasms - secondary; Male; Medical treatment; Middle Aged; Mortality; Skin Neoplasms - pathology; Sunscreen; Tomography; Tumors
• ISSN: 0003-1348; 1555-9823
• DOI: 10.1177/000313481307900603

Basal cell carcinoma can spread through lymphatic or hematogenous dissemination with equal frequency.1 The most frequent site of metastasis is to regional lymph nodes (60%) followed by lung (42%), bone (20%), or skin (10%).2 Metastases to the liver, other visceral organs, and subcutaneous tissues have also been reported.1 These metastatic lesions can be asymptomatic or can present with symptoms such as lymphadenopathy, ulceration, anemia, bone pain, and muscle weakness depending on the site of metastasis.2 Unlike our patient, who presented with a solitary pulmonary nodule, most pulmonary metastases are bilateral disseminated pulmonary nodules that originate from hematogenous spread.2 Metastatic basal cell carcinoma is defined by the following criteria: 1) the primary tumor must arise from the skin and not mucous membrane or glandular tissue; 2) both the metastases and the primary lesion must have similar pathologic appearances and cannot be squamous cell carcinoma; and 3) metastases must be shown in lymph nodes or viscera and cannot be a result of direct extension.3 Our patient's tumor fulfilled all of these criteria.