Yadranko Ducic1, Diego E Marra. 1. Otolaryngology and Facial Plastic Surgery Associates, Fort Worth, Texas, USA. yducic@sbcglobal.net
Abstract
OBJECTIVE: The purpose of this study is to review our series of metastatic basal cell carcinomas of the head and neck. STUDY DESIGN: A retrospective review was conducted for this study. METHODS: All cases of documented metastatic basal cell carcinomas arising from a primary within the head and neck region and presenting for treatment to one of the authors (Y.D.) were included in this review. RESULTS: Nine patients were available for review. Five patients had extension to but not transgression of the base of skull. Sites for metastatic disease included 4 lungs and 5 parotid glands. All metastatic lesions were treated with surgical excision, and 6 also received postoperative radiation therapy. No patient deaths from disease have been noted at an average follow-up of 4.7 years (range, 3-8.5 years). No evidence of further metastatic disease has been noted in any of these patients on follow-up. CONCLUSIONS: Metastatic basal cell carcinoma arising from a head and neck primary is a rare entity. However, initial involvement of the skull base and/or dura by a basal cell carcinoma appears to warrant a complete metastatic workup and metastatic surveillance. When metastatic disease is discovered, it appears to be well treated by surgical resection with/without adjunctive radiation therapy. We do not favor chemotherapy for resectable basal cell carcinomas.
OBJECTIVE: The purpose of this study is to review our series of metastatic basal cell carcinomas of the head and neck. STUDY DESIGN: A retrospective review was conducted for this study. METHODS: All cases of documented metastatic basal cell carcinomas arising from a primary within the head and neck region and presenting for treatment to one of the authors (Y.D.) were included in this review. RESULTS: Nine patients were available for review. Five patients had extension to but not transgression of the base of skull. Sites for metastatic disease included 4 lungs and 5 parotid glands. All metastatic lesions were treated with surgical excision, and 6 also received postoperative radiation therapy. No patient deaths from disease have been noted at an average follow-up of 4.7 years (range, 3-8.5 years). No evidence of further metastatic disease has been noted in any of these patients on follow-up. CONCLUSIONS:Metastatic basal cell carcinoma arising from a head and neck primary is a rare entity. However, initial involvement of the skull base and/or dura by a basal cell carcinoma appears to warrant a complete metastatic workup and metastatic surveillance. When metastatic disease is discovered, it appears to be well treated by surgical resection with/without adjunctive radiation therapy. We do not favor chemotherapy for resectable basal cell carcinomas.