SURFACE FORM OF BASAL CELL CARCINOMA OF THE SKIN: BIOLOGICAL BEHAVIOR, MORPHOLOGY AND CLINICAL VARIANTS

Abstract

The superficial form of basal cell carcinoma (BCC) is a malignant skin epithelial tumor with the most favorable flow profile and the least aggressive morphological structure among all known forms of BCC. Surface variants of BCC are characterized by a long and more benign course, slow, long-term growth. However, in the late stages of development, some researchers note the appearance of severe infiltration and destructive changes, ulceration of the BCC foci. Despite the fact that the surface form of the BCC is characterized by a long-term benign course, data have been obtained according to which the histologically confirmed surface multicentric form of BCC initially localized on the trunk increases the number of foci considerably faster than other localization and histological pattern. Objective: To study clinical and morphological features of the surface form of basal cell carcinoma based on monitoring 2500 cases of basal cell carcinoma. Material and methods. The authors analyzed literature sources and their own clinical and morphological data for 2500 clinical observations of patients with different clinical variants of BCC. Results. 2500 cases of BCC were analyzed. Among them 522 cases of clinical variants of surface form of BCC were revealed. Clinical and morphological monitoring was carried out taking into account the sex and age of patients, the variety and the primary localization of the disease, as well as the number and size of lesions. According to our monitoring data, 2500 cases of BCC registered in Moscow and the Moscow Region over the past 10 years, the frequency of the surface form in the overall structure of all BCC cases is 22.3% (557.5 cases), which is generally consistent with the reports of other authors. According to our data, the surface form of the BCC is localized mainly on the skin of trunk, extremities and much less often on the face. Women suffer from this form of BCC 2 times more often than men (371.6 and 185.8, respectively). We have not received convincing data on the predominant morbidity of this type of BCC of younger age groups, which, however, can be explained by the peculiarities of the patients’ mentality (often long unsuccessful self-treatment, rare medical attention), as well as the long practically asymptomatic course of the disease. The majority (80.3%) of the tumors corresponded to the TIN0M0 characteristic. On the body and limbs, the foci are more localized in men than in women (38.8 and 27.3%, respectively), while in the head (face, neck) - in women (72.7 and 61.2%, respectively). A rare type of surface form is a self-scaring BCC (Pejetoid epithelioma of Little). It is characterized by pronounced centrifugal growth. It is possible to transform the surface form of BCC into a more aggressive - nodular form.