Metastatic basal cell carcinoma: a case report and literature review. How accurate is our incidence data?

A 55-year-old man presented to Skin Cancer Surgery Center of Sacramento in 1995 for Mohs micrographic surgery of a 1.5-cm nodular basal cell carcinoma located on the right superior antihelix and scaphoid fossa. The tumor was excised by Mohs micrographic surgery. A recurrent basal cell carcinoma developed at the same site 5 years later and was treated also by Mohs micrographic surgery. One year later (approximately 6 years after the diagnosis of the initial basal cell carcinoma), a right parotid mass was noted on routine physical exam. CT scan and fine needle aspiration of the mass revealed metastatic basal cell carcinoma. The patient underwent excision of the parotid mass followed by radiation therapy. He has done well for the past 2 years since the diagnosis of his metastatic lesion. Basal cell carcinoma is the most common malignancy in the world. The metastatic potential of this tumor has been a cause for concern to many of our patients. We report a case of basal cell carcinoma metastatic to the parotid gland and critically review the incidence data reported in the literature. We recommended the collection of more current and accurate incidence data for basal cell carcinoma and metastatic basal cell carcinoma.