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Review, Pathogenesis, and Report of Two Cases

George R. Mikhail, MD; Linda P. Nims, MD; Alexander P. Kelly, Jr, MD; Donald M. Ditmars, Jr, MD; William R. Eyler, MD

Arch Dermatol. 1977;113(9):1261-1269.

Abstract
• In 93 reported cases of metastatic basal cell carcinoma (BCC), 76 had spread through lymphatics or blood vessels. Two more cases are presented, bringing the total to 78. Metastasis to regional lymph nodes was the most frequent, followed in frequency by lungs, bones, and other organs. The size of the primary tumor, its site, its resistance to x-ray therapy, and the effects of radiation appeared to contribute to the occurrence of metastasis. However, in an appreciable number of cases, tumor dissemination was related to incomplete excision followed by immediate wound closure, particularly by grafting. It is recommended that wound grafting be delayed for at least six months after excision of large or recurrent BCC in order to assure complete removal.

(Arch Dermatol 113:1261-1269, 1977)

Author Affiliations
From the Department of Dermatology (Drs Mikhail and Nims), the Division of Plastic Surgery (Drs Kelly and Ditmars), and the Department of Diagnostic Radiology (Dr Eyler), Henry Ford Hospital, Detroit.

Footnotes
Accepted for publication Oct 11, 1976.

Read before the 96th annual meeting of the American Dermatological Association, Inc, Williamsburg, Va, May 11, 1976.

Reprint requests to Department of Dermatology, Henry Ford Hospital, 2799 W Grand Blvd, Detroit, MI 48202 (Dr Mikhail).

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