Basal-cell carcinomas in the center of the face: special diagnostic, prognostic, and therapeutic considerations.

In a review of 848 successive cases of basal-cell carcinomas treated during 1976 in the Chemosurgery Unit of the New York University Medical Center by far most were found on the face and scalp (751/848 = 88.6%), and those in the triangle of the face formed by lines drawn from the outer canthi to the philtrum of the upper lip that includes the nose and its alae accounted for more than one-third of the entire number (316/848 = 37.2%) or two-fifths (316/764 = 41.4%) of those on the head and neck. Further analysis of our data showed the basal-cell carcinomas in the center of the face tended to be more invasive, more destructive, more recurrent, and more difficult to treat than were those in other sites. The reasons for seriousness and difficulty in management of basal-cell carcinomas and special diagnostic, prognostic, and therapeutic considerations pertaining to them are illustrated by representative case reports.