What Is Superficial Basal Cell Carcinoma?

Basal cell carcinoma (BCC) is the most common skin malignant tumor, accounting for 65% to 75% of all skin tumors. Basal cells derived from the skin or attachments, especially the hair follicles, are a low-grade malignancy.

Head and face basal cell carcinoma

This entry lacks an information bar and an overview map . Supplementing related content makes the entry more complete and can be upgraded quickly. Come on!

Basal cell carcinoma (BCC) is the most common skin malignant tumor, accounting for 65% to 75% of all skin tumors. Basal cells derived from the skin or attachments, especially the hair follicles, are a low-grade malignancy.

Basal cell epithelioma, erosion ulcer, base cancer

ICD: M8090 / 1

neurosurgery

Basal cell carcinoma is early manifested by local skin with slightly raised, pale yellow or pink nodules, only the size of a needle or mung bean, translucent nodules, hard, thin epidermis, and capillary dilatation, but no pain or tenderness.

Basal cell carcinoma (BCC) is the most common skin malignant tumor, accounting for 65% to 75% of all skin tumors.

Basal cell carcinoma is early manifested by local skin with slightly raised, pale yellow or pink nodules, only the size of a needle or mung bean, translucent nodules, hard, thin epidermis, and capillary dilatation, but no pain or tenderness. The lesions are located deep in the epidermis, the surface of the skin is slightly sunken, and the luster and texture of the normal skin are lost. After months or years, there are scale-like desquamations, and subsequent scabs, desquamations, and ulceration and bleeding. When the lesions continued to grow, superficial ulcers formed in the middle, and the edges were uneven, like worm-eaten. There are various surface formations, which can be roughly divided into the following types:

1. Nodular ulcer type is more common, the damage is single, from the size of the needle to the size of mung beans, showing a translucent nodule, hard, thin surface, with capillary dilatation, bleeding after minor trauma. Then it gradually increased, the central depression, erosion or ulceration on the surface, the bottom of the ulcer was granular or granulated, cauliflower-like, covered with serous secretions; the edges continued to expand, and most of the light gray pearl-like nodules were visible. Knots, uneven rolled up inward. This is a typical clinical morphology of this cancer and is called erosive ulcer.

2. Superficial type is rare. It is more common in men, with an earlier age of onset and very few heads.

3. Local sclerosis is rare and occurs in the face, forehead, palate, nose and eyes. The lesions were solitary, showing flat or slightly bulging infiltrated masses, irregular or Portuguese-shaped, ranging in size from a few millimeters to occupying the entire forehead, gray to pale yellow, smooth surface, and visible capillary dilatation. Slow growth, harder touch, more ulceration, similar to localized scleroderma.

4. Scar cancer is rare, mostly in the face, and the damage is superficial nodular plaque, which grows slowly.

5. Pigmented basal cell carcinoma is the pigmentation of the above types.

Basal cell carcinoma originates from the skin or appendages, especially the basal cells of the hair follicle, and is a low-grade malignant tumor.

Basal cell carcinoma originates from pluripotent basal-like cells on the surface or skin attachment, and can be differentiated in multiple directions. Cancer cells look like basal cells in an oval or spindle shape, with deep nucleus staining, less cytoplasm, and unclear cell boundaries. There is a basal band between the parenchyma and the stroma that is positive for PAS staining. Fibroblast proliferation in interstitial connective tissue. The stroma is mucus-like because it contains a large amount of acidic mucopolysaccharides. When the specimen is fixed and dehydrated, the mucin in the stroma shrinks, causing some or all of the stroma to separate from the tumor. However, this phenomenon is distinguished pathologically from tumors such as squamous cell carcinoma.

Diagnosis: When basal cell carcinoma has typical characteristics, such as nodules that are easy to identify when the nodule exceeds several millimeters, a diagnosis can be made based on clinical manifestations.

Laboratory inspection: No special manifestations.

Other auxiliary examinations: no special manifestations.

Early pigmented basal cell carcinoma is indistinguishable from molluscum contagiosum and senile dermal hyperplasia. The latter can be seen in the center of the lesion with keratin-like depressions. When there are obvious scabs or scales on the surface of basal cell carcinoma, they should be distinguished from common warts, keratoacanthoma and squamous cell carcinoma. And pigmented basal cell carcinoma can be misdiagnosed as melanoma. Basal cell carcinoma has inwardly rolled edges, telangiectasias, brown color, and no pigmented halo around it. Superficial basal cell carcinoma is quite similar to eczema, lichen planus, and psoriasis, but it should be noted that the linear edges are not clear and can be distinguished from local scleroderma. But it is often determined by pathological examination.

Basal cell carcinoma is sensitive to radiation and is generally treated with radiation.

1. The dose and irradiation range of radiation therapy depends on the size of the lesion: For lesions with a diameter of <1cm, the superficial ones can be treated with 50kV contact, the total dose is 22Gy; for lesions with a diameter of <5cm, a thickness of 5cm, and those with deeper infiltration, 160 180kV split treatment, the course of treatment is 3-5 weeks, the total dose is 45-60Gy. The advantage of radiation therapy is that it has good curative effect without leaving scars on the head and face. However, it is not applicable to local scleroderma-like basal cell carcinoma.

2. Chemotherapy For those without lymphatic metastasis, basal cell carcinoma of the head and face generally does not advocate systemic chemotherapy, and more local anti-cancer drugs are applied.

(1) Apply 1% to 5% 5-chlorouracil ointment, once in the morning and evening, for 2 to 3 weeks. Local erosion may occur. Use antibiotic ointment instead.

(2) 20% Zhisu ointment, skin cancer, net use of Pingyang toxin 15mg, once per day, the total dose of 600 ~ 900mg, for large lesions, the effect of local medication should be used with caution.

3. Cryotherapy is suitable for basal cell carcinoma that is rich in fiber and has small lesions. The center of the lesion and the surrounding normal tissue of 2 to 5 cm are used as the treatment area. The liquid nitrogen is sprayed to the center of the cancer, which usually lasts for about 30s to reduce the local temperature to -20 ° C and then slowly thaw. If there is no accurate thermometer test, it can be used to roughly estimate whether the freezing is sufficient according to the time required from cessation of liquid nitrogen to thawing. Generally, the small lesions on the head, neck, and face are at least 1.5 minutes, and often need to be repeated. Thaw twice, and the second time can be adjusted according to the degree of the first treatment. When tumor tissue necrosis comes off, rinse with normal saline and apply antibiotic ointment.

2 times / d, the wound can be completely healed in 3 to 4 weeks. It has been reported that after cryotherapy, the recurrence rate of basal scalp cancer is high, so it is considered unsuitable.

4. Laser treatment commonly used CO2 laser and Nd: YAG. Cutting with high energy, low energy coagulation, suitable for superficial tumors, the advantage is less damage, good repair, the disadvantage is the lack of pathological examination of the marginal tissue.

5. Surgical treatment For patients with lesions> 1 cm, surgery is still the main therapy, and combined with radiotherapy if necessary.

(1) curettage surgery: suitable for superficial, smaller basal cell carcinoma. Under local anesthesia, first use a 3 to 4 mm curette to scrape the surrounding and basal residual tumor tissue. It is best to use electrocoagulation for cauterization. Applying antibiotic ointment to the wound has the advantage that the wound is small. Suitable for face and forehead.

(2) Chemical Surgery: American physician Mohs pioneered the use of zinc chloride paste to fix tumors and cut them horizontally for pathological examinations. Each cut was submitted for examination until there was no cancerous tissue. It is no longer necessary to use zinc chloride paste to cut fresh tissue directly in the horizontal direction. This method is suitable for larger tumors, and the cure rate is 99%, which is technically difficult. Some people think that there is no essential difference between this method and surgical resection and frozen section examination.

(3) Surgical resection: According to the size of the focus and the presence or absence of metastasis, the incision range and operation depth are determined. When the tumor penetrates into the skull, the affected skull and even the dura mater should be removed at the same time, followed by repair and skin grafting.

no.

Prognosis: Basal cell carcinoma grows slowly, lymph node metastasis rarely occurs, and the prognosis is good.

Prevention: No special.

Basal cell carcinoma accounts for 50% to 65% of skin cancer abroad. Squamous carcinoma is more common in Chinese skin cancer, and the ratio to basal cell carcinoma is 5: 1 to 10: 1.