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Diagnosis and Management of Basal Cell Carcinoma

  • Skin Cancer (T Ito, Section Editor)
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Opinion statement

Basal cell carcinomas (BCCs) are common skin cancers that tend to appear on sun-exposed skin. Pathobiologically, activation of the Hedgehog signaling pathway characterizes the majority of cases. In general, BCCs are slow-growing and rarely metastasize. Nevertheless, they are locally invasive and can be destructive. While typical cases are diagnosed based on clinical findings, the clinicopathological manifestations are varied. Consequently, skin biopsy is essential to confirm the diagnosis and evaluate the risk of recurrence. In the treatment of primary lesions, the initial goal is to complete tumor removal, whether by conventional surgical excision, Mohs micrographic surgery, cryosurgery, electrodesiccation and curettage, topical application of imiquimod or fluorouracil, photodynamic therapy, or radiation therapy. Of these treatments, surgical excision and Mohs surgery are the most commonly used because of their association with a low recurrence rate and the ability to confirm residual tumor pathologically. However, other treatment options may be preferred according to patient condition, tumor location, and risk of recurrence. In the treatment of metastatic or locally advanced lesions, smoothened inhibitors, which inhibit Hedgehog signaling pathway activation, were recently approved and impressive tumor shrinkage effects have been described. Although the exact prognosis of metastatic BCC has not been analyzed, it is probably poor due to the rarity of such condition. However, emerging molecular targeting agents hold therapeutic promise.

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References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: • Of importance

  1. Roenigk RK, Ratz JL, Bailin PL, Wheeland RG. Trends in the presentation and treatment of basal cell carcinomas. J Dermatol Surg Oncol. 1986;12:860–5.

    CAS  PubMed  Google Scholar 

  2. Lo J, Snow S, Reizner G. Metastatic basal cell carcinoma: a report of twelve cases with a review of the literature. J Am Acad Dermatol. 1991;24:715–9.

    CAS  PubMed  Google Scholar 

  3. van Dam RM, Huang Z, Rimm EB, Weinstock MA, Spiegelman D, Colditz GA, et al. Risk factors for basal cell carcinoma of the skin in men: results from the health professionals follow-up study. Am J Epidemiol. 1999;150:459–68.

    PubMed  Google Scholar 

  4. Zanetti R, Rosso S, Martinez C, Nieto A, Miranda A, Mercier M, et al. Comparison of risk patterns in carcinoma and melanoma of the skin in men: a multi-Centre case-case-control study. Br J Cancer. 2006;94:743–51.

    CAS  PubMed  PubMed Central  Google Scholar 

  5. Karagas MR, Tosteson TD, Blum J, Morris JS, Baron JA, Klaue B. Design of an epidemiologic study of drinking water arsenic exposure and skin and bladder cancer risk in a U.S. population. Environ Health Perspect. 1998;106(Suppl 4):1047–50.

    PubMed  PubMed Central  Google Scholar 

  6. Tao SS, Bolger PM. Dietary arsenic intakes in the United States: FDA total diet study, September 1991-December 1996. Food Addit Contam. 1999;16:465–72.

    CAS  PubMed  Google Scholar 

  7. Boonchai W, Green A, Ng J, Dicker A, Chenevix-Trench G. Basal cell carcinoma in chronic arsenicism occurring in Queensland, Australia, after ingestion of an asthma medication. J Am Acad Dermatol. 2000;43:664–9.

    CAS  PubMed  Google Scholar 

  8. Lichter MD, Karagas MR, Mott LA, Spencer SK, Stukel TA, Greenberg ER. Therapeutic ionizing radiation and the incidence of basal cell carcinoma and squamous cell carcinoma. The New Hampshire skin cancer study group. Arch Dermatol. 2000;136:1007–11.

    CAS  PubMed  Google Scholar 

  9. Watt TC, Inskip PD, Stratton K, Smith SA, Kry SF, Sigurdson AJ, et al. Radiation-related risk of basal cell carcinoma: a report from the childhood cancer survivor study. J Natl Cancer Inst. 2012;104:1240–50.

    PubMed  PubMed Central  Google Scholar 

  10. Euvrard S, Kanitakis J, Claudy A. Skin cancers after organ transplantation. N Engl J Med. 2003;348:1681–91.

    PubMed  Google Scholar 

  11. Silverberg MJ, Leyden W, Warton EM, Quesenberry CP Jr, Engels EA, Asgari MM. HIV infection status, immunodeficiency, and the incidence of non-melanoma skin cancer. J Natl Cancer Inst. 2013;105:350–60.

    CAS  PubMed  PubMed Central  Google Scholar 

  12. Tanese K, Emoto K, Kubota N, Fukuma M, Sakamoto M. Immunohistochemical visualization of the signature of activated hedgehog signaling pathway in cutaneous epithelial tumors. J Dermatol. 2018;45:1181–6.

    CAS  PubMed  Google Scholar 

  13. Bakshi A, Chaudhary SC, Rana M, Elmets CA, Athar M. Basal cell carcinoma pathogenesis and therapy involving hedgehog signaling and beyond. Mol Carcinog. 2017;56:2543–57.

    CAS  PubMed  PubMed Central  Google Scholar 

  14. Epstein EH. Basal cell carcinomas: attack of the hedgehog. Nat Rev Cancer. 2008;8:743–54.

    CAS  PubMed  PubMed Central  Google Scholar 

  15. Hatta N, Hirano T, Kimura T, Hashimoto K, Mehregan DR, Ansai S, et al. Molecular diagnosis of basal cell carcinoma and other basaloid cell neoplasms of the skin by the quantification of Gli1 transcript levels. J Cutan Pathol. 2005;32:131–6.

    PubMed  Google Scholar 

  16. Pellegrini C, Maturo MG, Di Nardo L, Ciciarelli V, Gutiérrez García-Rodrigo C, Fargnoli MC. Understanding the molecular genetics of basal cell carcinoma. Int J Mol Sci. 2017;18:2485. https://doi.org/10.3390/ijms18112485.

    Article  CAS  PubMed Central  Google Scholar 

  17. Johnson RL, Rothman AL, Xie J, Goodrich LV, Bare JW, Bonifas JM, et al. Human homolog of patched, a candidate gene for the basal cell nevus syndrome. Science. 1996;272:1668–71.

    CAS  Google Scholar 

  18. Xie J, Murone M, Luoh SM, Ryan A, Gu Q, Zhang C, et al. Activating smoothened mutations in sporadic basal-cell carcinoma. Nature. 1998;391:90–2.

    CAS  Google Scholar 

  19. Lomas A, Leonardi-Bee J, Bath-Hextall F. A systematic review of worldwide incidence of nonmelanoma skin cancer. Br J Dermatol. 2012;166:1069–80.

    CAS  PubMed  Google Scholar 

  20. Richmond-Sinclair NM, Pandeya N, Ware RS, Neale RE, Williams GM, van der Pols JC, et al. Incidence of basal cell carcinoma multiplicity and detailed anatomic distribution:longitudinal study of an Australian population. J Invest Dermatol. 2009;129:323–8.

    CAS  PubMed  Google Scholar 

  21. Munyao TM, Othieno-Abinya NA. Cutaneous basal cell carcinoma in Kenya. East Afr Med J. 1999;76:97–100.

    CAS  PubMed  Google Scholar 

  22. Ichihashi M, Naruse K, Harada S, Nagano T, Nakamura T, Suzuki T, et al. Trends in nonmelanoma skin cancer in Japan. Recent Results Cancer Res. 1995;139:263–73.

    CAS  PubMed  Google Scholar 

  23. Chuang TY, Popescu A, Su WP, Chute CG. Basal cell carcinoma. A population-based incidence study in Rochester, Minnesota. J Am Acad Dermatol. 1990;22:413–7.

    CAS  PubMed  Google Scholar 

  24. Reizner GT, Chuang TY, Elpern DJ, Stone JL, Farmer ER. Basal cell carcinoma in Kauai, Hawaii: the highest documented incidence in the United States. J Am Acad Dermatol. 1993;29:184–9.

    CAS  PubMed  Google Scholar 

  25. Wu S, Han J, Li WQ, Li T, Qureshi AA. Basal-cell carcinoma incidence and associated risk factors in US women and men. Am J Epidemiol. 2013;178:890–7.

    PubMed  PubMed Central  Google Scholar 

  26. Altamura D, Menzies SW, Argenziano G, Zalaudek I, Soyer HP, Sera F, et al. Dermatoscopy of basal cell carcinoma: morphologic variability of global and local features and accuracy of diagnosis. J Am Acad Dermatol. 2010;62:67–75.

    PubMed  Google Scholar 

  27. Zalaudek I, Kreusch J, Giacomel J, Ferrara G, Catricalà C, Argenziano G. How to diagnose nonpigmented skin tumors: a review of vascular structures seen with dermoscopy: part II. Nonmelanocytic skin tumors. J Am Acad Dermatol. 2010;63:377–86.

    PubMed  Google Scholar 

  28. Patterson JW. Weedon’s skin pathology. 4th ed. London: Churchill-Livingstone; 2016. p. 806–11.

    Google Scholar 

  29. Tanese K, Fukuma M, Yamada T, Mori T, Yoshikawa T, Watanabe W, et al. G-protein-coupled receptor GPR49 is up-regulated in basal cell carcinoma and promotes cell proliferation and tumor formation. Am J Pathol. 2008;173:835–43.

    CAS  PubMed  PubMed Central  Google Scholar 

  30. Sellheyer K, Krahl D. Basal cell (trichoblastic) carcinoma common expression pattern for epithelial cell adhesion molecule links basal cell carcinoma to early follicular embryogenesis, secondary hair germ, and outer root sheath of the vellus hair follicle: a clue to the adnexal nature of basal cell carcinoma? J Am Acad Dermatol. 2008;58:158–67.

    PubMed  Google Scholar 

  31. Sexton M, Jones DB, Maloney ME. Histologic pattern analysis of basal cell carcinoma. Study of a series of 1039 consecutive neoplasms. J Am Acad Dermatol. 1990;23:1118–26.

    CAS  PubMed  Google Scholar 

  32. Dourmishev LA, Rusinova D, Botev I. Clinical variants, stages, and management of basal cell carcinoma. Indian Dermatol Online J. 2013;4:12–7.

    PubMed  PubMed Central  Google Scholar 

  33. Scrivener Y, Grosshans E, Cribier B. Variations of basal cell carcinomas according to gender, age, location and histopathological subtype. Br J Dermatol. 2002;147:41–7.

    CAS  PubMed  Google Scholar 

  34. Popadić M. Dermoscopic features in different morphologic types of basal cell carcinoma. Dermatol Surg. 2014;40:725–32.

    PubMed  Google Scholar 

  35. Rosai J. Rosai and Ackerman’s surgical pathology. 9th ed. Edinburgh: Mosby; 2004. p. 136–9.

    Google Scholar 

  36. Wozniak-Rito A, Zalaudek I, Rudnicka L. Dermoscopy of basal cell carcinoma. Clin Exp Dermatol. 2018;43:241–7.

    CAS  PubMed  Google Scholar 

  37. Lallas A, Argenziano G, Kyrgidis A, Apalla Z, Moscarella E, Longo C, et al. Dermoscopy uncovers clinically undetectable pigmentation in basal cell carcinoma. Br J Dermatol. 2014;170:192–5.

    CAS  PubMed  Google Scholar 

  38. Tabanlıoğlu Onan D, Sahin S, Gököz O, Erkin G, Cakır B, Elçin G, et al. Correlation between the dermatoscopic and histopathological features of pigmented basal cell carcinoma. J Eur Acad Dermatol Venereol. 2010;24:1317–25.

    PubMed  Google Scholar 

  39. Peris K, Altobelli E, Ferrari A, Fargnoli MC, Piccolo D, Esposito M, et al. Interobserver agreement on dermoscopic features of pigmented basal cell carcinoma. Dermatol Surg. 2002;28:643–5.

    PubMed  Google Scholar 

  40. National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: Basal cell skin cancer. https://www.nccn.org/professionals/physician_gls/f_guidelines.asp.Accessed 28 Nov, 2018.

  41. Silverman MK, Kopf AW, Bart RS, Grin CM, Levenstein MS. Recurrence rates of treated basal cell carcinomas. Part 3: surgical excision. J Dermatol Surg Oncol. 1992;18:471–6.

    CAS  PubMed  Google Scholar 

  42. Wolf DJ, Zitelli JA. Surgical margins for basal cell carcinoma. Arch Dermatol. 1987;123:340–4.

    CAS  PubMed  Google Scholar 

  43. Gulleth Y, Goldberg N, Silverman RP, Gastman BR. What is the best surgical margin for a basal cell carcinoma: a meta-analysis of the literature. Plast Reconstr Surg. 2010;126:1222–31.

    CAS  PubMed  Google Scholar 

  44. Telfer NR, Colver GB, Morton CA. British Association of Dermatologists. Guidelines for the management of basal cell carcinoma. Br J Dermatol. 2008;159:35–48.

    CAS  PubMed  Google Scholar 

  45. European Dermatology Forum. Guideline on the treatment of basal cell carcinoma. https://www.euroderm.org/dam/jcr:d69bdaac-4b86-4cc5-bd41-ba0a5036f96b/Guidelines-on-Basal-Cell-Carcinoma_Update2012_prolonged-until2017.pdf. Accessed 28 Nov, 2018.

  46. Tuchida T, Koga H, Uhara H, Kiyohara T, Takenouchi T, Ansai S, et al. Japanese guideline of skin cancer 2nd edition. Jpn J Dermatol. 2015;125:5–75.

    Google Scholar 

  47. Nakamura Y, Tanese K, Hirai I, Kameyama K, Kawakami Y, Amagai M, et al. Evaluation of the appropriate surgical margin for pigmented basal cell carcinoma according to the risk factors for recurrence: a single-institute retrospective study in Japan. J Eur Acad Dermatol Venereol. 2018;32:e453–5. https://doi.org/10.1111/jdv.15046.

    Article  CAS  PubMed  Google Scholar 

  48. Ito T, Inatomi Y, Nagae K, Nakano-Nakamura M, Nakahara T, Furue M, et al. Narrow-margin excision is a safe, reliable treatment for well-defined, primary pigmented basal cell carcinoma: an analysis of 288 lesions in Japan. J Eur Acad Dermatol Veneol. 2015;29:1828–31.

    CAS  Google Scholar 

  49. Muller FM, Dawe RS, Moseley H, Fleming CJ. Randomized comparison of Mohs micrographic surgery and surgical excision for small nodular basal cell carcinoma: tissue-sparing outcome. Dermatol Surg. 2009;35:1349–54.

    CAS  PubMed  Google Scholar 

  50. Smeets NW, Krekels GA, Ostertag JU, Essers BA, Dirksen CD, Nieman FH, et al. Surgical excision vs Mohs' micrographic surgery for basal-cell carcinoma of the face: randomised controlled trial. Lancet. 2004;364:1766–72.

    PubMed  Google Scholar 

  51. Mosterd K, Krekels GA, Nieman FH, Ostertag JU, Essers BA, Dirksen CD, et al. Surgical excision versus Mohs' micrographic surgery for primary and recurrent basal-cell carcinoma of the face: a prospective randomised controlled trial with 5-years' follow-up. Lancet Oncol. 2008;9:1149–56.

    PubMed  Google Scholar 

  52. van Loo E, Mosterd K, Krekels GA, Roozeboom MH, Ostertag JU, Dirksen CD, et al. Surgical excision versus Mohs' micrographic surgery for basal cell carcinoma of the face: a randomised clinical trial with 10 year follow-up. Eur J Cancer. 2014;50:3011–20.

    PubMed  Google Scholar 

  53. Malhotra R, Huilgol SC, Huynh NT, Selva D. The Australian Mohs database, part II: periocular basal cell carcinoma outcome at 5-year follow-up. Ophthalmology. 2004;111:631–6.

    PubMed  Google Scholar 

  54. Sebaratnam DF, Choy B, Lee M, Paver R, Fernández PP. Direct cost-analysis of Mohs micrographic surgery and traditional excision for basal cell carcinoma at initial margin clearance. Dermatol Surg. 2016;42:633–8.

    CAS  PubMed  Google Scholar 

  55. Thissen MR, Neumann MH, Schouten LJ. A systematic review of treatment modalities for primary basal cell carcinomas. Arch Dermatol. 1999;135:1177–83.

    CAS  PubMed  Google Scholar 

  56. Silverman MK, Kopf AW, Bart RS, Grin CM, Levenstein MS. Recurrence rates of treated basal cell carcinomas. Part 2: curettage-electrodesiccation. J Dermatol Surg Oncol. 1991;17:720–6.

    CAS  PubMed  Google Scholar 

  57. Blixt E, Nelsen D, Stratman E. Recurrence rates of aggressive histologic types of basal cell carcinoma after treatment with electrodesiccation and curettage alone. Dermatol Surg. 2013;39:719–25.

    CAS  PubMed  Google Scholar 

  58. McDaniel WE. Therapy for basal cell epitheliomas by curettage only. Further study Arch Dermatol. 1983;119:901–3.

    CAS  PubMed  Google Scholar 

  59. Kuflik EG. Cryosurgery for skin cancer: 30-year experience and cure rates. Dermatol Surg. 2004;30:297–300.

    PubMed  Google Scholar 

  60. Hall VL, Leppard BJ, McGill J, Kesseler ME, White JE, Goodwin P. Treatment of basal-cell carcinoma: comparison of radiotherapy and cryotherapy. Clin Radiol. 1986;37:33–4.

    CAS  PubMed  Google Scholar 

  61. Kuijpers DI, Thissen MR, Berretty PJ, Ideler FH, Nelemans PJ, Neumann MH. Surgical excision versus curettage plus cryosurgery in the treatment of basal cell carcinoma. Dermatol Surg. 2007;33:579–87.

    CAS  PubMed  Google Scholar 

  62. Thissen MR, Nieman FH, Ideler AH, Berretty PJ, Neumann HA. Cosmetic results of cryosurgery versus surgical excision for primary uncomplicated basal cell carcinomas of the head and neck. Dermatol Surg. 2000;26:759–64.

    CAS  PubMed  Google Scholar 

  63. Schön M, Bong AB, Drewniok C, Herz J, Geilen CC, Reifenberger J, et al. Tumor-selective induction of apoptosis and the small-molecule immune response modifier imiquimod. J Natl Cancer Inst. 2003;95:1138–49.

    PubMed  Google Scholar 

  64. Geisse J, Caro I, Lindholm J, Golitz L, Stampone P, Owens M. Imiquimod 5% cream for the treatment of superficial basal cell carcinoma: results from two phase III, randomized, vehicle-controlled studies. J Am Acad Dermatol. 2004;50:722–33.

    PubMed  Google Scholar 

  65. McKay KM, Sambrano BL, Fox PS, Bassett RL, Chon S, Prieto VG. Thickness of superficial basal cell carcinoma (sBCC) predicts imiquimod efficacy: a proposal for a thickness-based definition of sBCC. Br J Dermatol. 2013;169:549–54.

    CAS  PubMed  Google Scholar 

  66. Shumack S, Robinson J, Kossard S, Golitz L, Greenway H, Schroeter A, et al. Efficacy of topical 5% imiquimod cream for the treatment of nodular basal cell carcinoma: comparison of dosing regimens. Arch Dermatol. 2002;138:1165–71.

    CAS  PubMed  Google Scholar 

  67. Eigentler TK, Kamin A, Weide BM, Breuninger H, Caroli UM, Möhrle M, et al. A phase III, randomized, open label study to evaluate the safety and efficacy of imiquimod 5% cream applied thrice weekly for 8 and 12 weeks in the treatment of low-risk nodular basal cell carcinoma. J Am Acad Dermatol. 2007;57:616–21.

    PubMed  Google Scholar 

  68. Bath-Hextall F, Ozolins M, Armstrong SJ, Colver GB, Perkins W, Miller PS, et al. Surgical excision versus imiquimod 5% cream for nodular and superficial basal-cell carcinoma (SINS): a multicentre, non-inferiority, randomised controlled trial. Lancet Oncol. 2014;15:96–105.

    CAS  PubMed  Google Scholar 

  69. • Williams HC, Bath-Hextall F, Ozolins M, Armstrong SJ, Colver GB, Perkins W, et al. Surgery versus 5% imiquimod for nodular and superficial basal cell carcinoma: 5-year results of the SINS randomized controlled trial. J Invest Dermatol. 2017;137:614–9 Randomized control trial comparing surgery and topical 5% imquimod cream. Surgery is clearly superior to imiquimod.

    CAS  PubMed  Google Scholar 

  70. Thomas DM, Zalcberg JR. 5-fluorouracil: a pharmacological paradigm in the use of cytotoxics. Clin Exp Pharmacol Physiol. 1998;25:887–95.

    CAS  PubMed  Google Scholar 

  71. Arits AH, Mosterd K, Essers BA, Spoorenberg E, Sommer A, De Rooij MJ, et al. Photodynamic therapy versus topical imiquimod versus topical fluorouracil for treatment of superficial basal-cell carcinoma: a single blind, non-inferiority, randomised controlled trial. Lancet Oncol. 2013;14:647–54.

    CAS  PubMed  Google Scholar 

  72. • Jansen MHE, Mosterd K, Arits AHMM, Roozeboom MH, Sommer A, Essers BAB, et al. Five-year results of a randomized controlled trial comparing effectiveness of photodynamic therapy, topical imiquimod, and topical 5-fluorouracil in patients with superficial basal cell carcinoma. J Invest Dermatol. 2018;138:527–33 Randomized control trial comparing topical 5% imiquimod cream, photodynamic therapy and topical 5-fluorouracil. Superiority of the 5% imiquimod cream was suggested for noninvasive treatment in most primary superficial basal cell carcinomas.

    CAS  PubMed  Google Scholar 

  73. Reymann F. Treatment of basal cell carcinoma of the skin with 5-fluorouracil ointment. A 10-year follow-up study. Dermatologica. 1979;158:368–72.

    CAS  PubMed  Google Scholar 

  74. Epstein E. Fluorouracil paste treatment of thin basal cell carcinomas. Arch Dermatol. 1985;121:207–13.

    CAS  PubMed  Google Scholar 

  75. Love WE, Bernhard JD, Bordeaux JS. Topical imiquimod or fluorouracil therapy for basal and squamous cell carcinoma: a systematic review. Arch Dermatol. 2009;145:1431–8.

    CAS  PubMed  Google Scholar 

  76. Foley P. Clinical efficacy of methyl aminolevulinate (Metvix) photodynamic therapy. J Dermatolog Treat. 2003;14(Suppl 3):15–22.

    CAS  PubMed  Google Scholar 

  77. Kalka K, Merk H, Mukhtar H. Photodynamic therapy in dermatology. J Am Acad Dermatol. 2000;42:389–413.

    CAS  PubMed  Google Scholar 

  78. Fantini F, Greco A, Del Giovane C, Cesinaro AM, Venturini M, Zane C, et al. Photodynamic therapy for basal cell carcinoma: clinical and pathological determinants of response. J Eur Acad Dermatol Venereol. 2011;25:896–901.

    CAS  PubMed  Google Scholar 

  79. Cosgarea R, Susan M, Crisan M, Senila S. Photodynamic therapy using topical 5-aminolaevulinic acid vs. surgery for basal cell carcinoma. J Eur Acad Dermatol Venereol. 2013;27:980–4.

    CAS  PubMed  Google Scholar 

  80. Szeimies RM, Ibbotson S, Murrell DF, Rubel D, Frambach Y, de Berker D, et al. A clinical study comparing methyl aminolevulinate photodynamic therapy and surgery in small superficial basal cell carcinoma (8-20 mm), with a 12-month follow-up. J Eur Acad Dermatol Venereol. 2008;22:1302–11.

    CAS  PubMed  Google Scholar 

  81. Mosterd K, Thissen MR, Nelemans P, Kelleners-Smeets NW, Janssen RL, Broekhof KG, et al. Fractionated 5-aminolaevulinic acid-photodynamic therapy vs. surgical excision in the treatment of nodular basal cell carcinoma: results of a randomized controlled trial. Br J Dermatol. 2008;159:864–70.

    CAS  PubMed  Google Scholar 

  82. Rhodes LE, de Rie MA, Leifsdottir R, Yu RC, Bachmann I, Goulden V, et al. Five-year follow-up of a randomized, prospective trial of topical methyl aminolevulinate photodynamic therapy vs surgery for nodular basal cell carcinoma. Arch Dermatol. 2007;143:1131–6.

    CAS  PubMed  Google Scholar 

  83. Silverman MK, Kopf AW, Gladstein AH, Bart RS, Grin CM, Levenstein MJ. Recurrence rates of treated basal cell carcinomas. Part 4: X-ray therapy. J Dermatol Surg Oncol. 1992;18:549–54.

    CAS  PubMed  Google Scholar 

  84. Rowe DE, Carroll RJ, Day CL Jr. Long-term recurrence rates in previously untreated (primary) basal cell carcinoma: implications for patient follow-up. J Dermatol Surg Oncol. 1989;15:315–28.

    CAS  PubMed  Google Scholar 

  85. Locke J, Karimpour S, Young G, Lockett MA, Perez CA. Radiotherapy for epithelial skin cancer. Int J Radiat Oncol Biol Phys. 2001;51:748–55.

    CAS  PubMed  Google Scholar 

  86. Wilder RB, Shimm DS, Kittelson JM, Rogoff EE, Cassady JR. Recurrent basal cell carcinoma treated with radiation therapy. Arch Dermatol. 1991;127:1668–72.

    CAS  PubMed  Google Scholar 

  87. Fleming ID, Amonette R, Monaghan T, Fleming MD. Principles of management of basal and squamous cell carcinoma of the skin. Cancer. 1995;75:699–704.

    CAS  PubMed  Google Scholar 

  88. Petit JY, Avril MF, Margulis A, Chassagne D, Gerbaulet A, Duvillard P, et al. Evaluation of cosmetic results of a randomized trial comparing surgery and radiotherapy in the treatment of basal cell carcinoma of the face. Plast Reconstr Surg. 2000;105:2544–51.

    CAS  PubMed  Google Scholar 

  89. Kirby JS, Miller CJ. Intralesional chemotherapy for nonmelanoma skin cancer: a practical review. J Am Acad Dermatol. 2010;63:689–702.

    CAS  PubMed  Google Scholar 

  90. von Domarus H, Stevens PJ. Metastatic basal cell carcinoma. Report of five cases and review of 170 cases in the literature. J Am Acad Dermatol. 1984;10:1043–60.

    Google Scholar 

  91. Wysong A, Aasi SZ, Tang JY. Update on metastatic basal cell carcinoma: a summary of published cases from 1981 through 2011. JAMA Dermatol. 2013;149:615–6.

    PubMed  Google Scholar 

  92. Von Hoff DD, LoRusso PM, Rudin CM, Reddy JC, Yauch RL, Tibes R, et al. Inhibition of the hedgehog pathway in advanced basal-cell carcinoma. N Engl J Med. 2009;361:1164–72.

    Google Scholar 

  93. Basset-Séguin N, Hauschild A, Kunstfeld R, Grob J, Dréno B, Mortier L, et al. Vismodegib in patients with advanced basal cell carcinoma: primary analysis of STEVIE, an international, open-label trial. Eur J Cancer. 2017;86:334–48.

    PubMed  Google Scholar 

  94. Migden MR, Guminski A, Gutzmer R, Dirix L, Lewis KD, Combemale P, et al. Treatment with two different doses of sonidegib in patients with locally advanced or metastatic basal cell carcinoma (BOLT): a multicentre, randomised, double-blind phase 2 trial. Lancet Oncol. 2015;16:716–28.

    CAS  PubMed  Google Scholar 

  95. Dummer R, Guminski A, Gutzmer R, Dirix L, Lewis KD, Combemale P, et al. The 12-month analysis from Basal Cell Carcinoma Outcomes with LDE225 Treatment (BOLT): A phase II, randomized, double-blind study of sonidegib in patients with advanced basal cell carcinoma. J Am Acad Dermatol. 2016;75:113–25. e5.

    CAS  PubMed  Google Scholar 

  96. Chang AL, Oro AE. Initial assessment of tumor regrowth after vismodegib in advanced basal cell carcinoma. Arch Dermatol. 2012;148:1324–5.

    PubMed  PubMed Central  Google Scholar 

  97. • Xie P, Lefrançois P. Efficacy, safety, and comparison of sonic hedgehog inhibitors in basal cell carcinomas: a systematic review and meta-analysis. J Am Acad Dermatol. 2018;79:1089–110.E.17 The latest meta-analysis and review of SMO inhibitors describing those efficacy and safety.

    CAS  PubMed  Google Scholar 

  98. Carneiro BA, Watkin WG, Mehta UK, Brockstein BE. Metastatic basal cell carcinoma: complete response to chemotherapy and associated pure red cell aplasia. Cancer Investig. 2006;24:396–400.

    Google Scholar 

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Tanese, K. Diagnosis and Management of Basal Cell Carcinoma. Curr. Treat. Options in Oncol. 20, 13 (2019). https://doi.org/10.1007/s11864-019-0610-0

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