Basal Cell Carcinoma of the Skin to Tirana-Albania

Abstract

Basal cell carcinoma (BCC) is the most frequent epithelial tumor of the skin, characterized by a local infiltrative growth in contrast to a very rarely metastatization. In rare cases this neoplastic process behaves aggressively with deep invasion and high recurrence risk after surgery. The pathogenesis and the factors that determine the extensive growth are not completely understood. The American Joint Committee on Cancer published on 1988 the morphologic characteristics necessary to define a BCC as giant. Only the 1% of all BCC achieves these parameters. Basal Cell Carcinoma is linked to a spontaneous mutation of PTCH gene situated in chromosome region 9q22.3. Environmental factors, as sun exposition, trauma or smoking, play an important role in the tumor development. The tumor on sets most frequently in the middle part of the face and scalp even that it can develop on all sun exposed skin. Aim of this study is to review the available literature on BBCs. Between April 2014 and March 2015, 50 patients with BCC were treated in the Department of Plastic and Reconstructive Surgery of Tirana. According to the AJCC classification, 40 tumors were T1 (80%), 5 tumors were T2 (10%) and 5 were T3 (5%). All patients received surgical excision of neoformation and immediate reconstruction. For small BCC (1-2cm), the surgical excisions require clinical margin of 3-5mm and the recurrence risk in this tumor is 4%-14%. Actually the gold standard is to perform a one-step or two-step surgery. In one step surgery the surgical defect is close directly and the reconstructive procedure is definitive. One step surgery, using Mohs Micrographic surgery, affords superior clinical outcomes, with a five-years tumor-free rate of over 99% for primary BCC and over 95% for recurrent BCC, compared to the rate of 93% and 80% respectively for other interventions. Collected data from our personal experience, according with the literature review, demonstrate that early diagnosis on association with the correct treatment is the only strategy to have a good prognosis of the disease.

DOI: 10.5901/ajis.2015.v4n2s2p100