Histologic pattern analysis of basal cell carcinoma: Study of a series of 1039 consecutive neoplasms

https://doi.org/10.1016/0190-9622(90)70344-HGet rights and content

This study attempts to define histologic patterns in 1039 consecutive cases of basal cell carcinoma and to correlate these patterns with adequacy of margins of surgical excision. Five major histologic patterns were identified: nodular, 218 cases (21%); superficial, 181 cases (17%); micronodular, 151 cases (15%); infiltrative, 77 cases (7%); and morpheic, 11 cases (1%). A mixed pattern (two or more major histologic patterns) was present in 401 cases (38.5%). Our study indicates that nodular and superficial basal cell carcinomas can be completely removed by simple surgical excision in a high percentage of cases (93.6% and 96.4%, respectively) whereas the micronodular, infiltrative, and morpheic basal cell carcinomas have a higher incidence of positive tumor margins (18.6%, 26.5%, and 33.3%, respectively) after excision. Mixed patterns that consisted of combinations of the nodular, micronodular, or infiltrative types exhibited a behavior similar to the pattern that resulted in a greater chance of incomplete surgical removal.

References (20)

  • PG Lang et al.

    Histologic evolution of recurrent basal cell carcinoma and treatment implications

    J Am Acad Dermatol

    (1986)
  • HV Domarus et al.

    Metastatic basal cell carcinoma

    J Am Acad Dermatol

    (1984)
  • TJ Litzow et al.

    Morpheaform basal cell carcinoma

    Am J Surg

    (1968)
  • WF Lever et al.
  • AH Mehregan
  • RR Pascal et al.

    Prognosis of “incompletely excised” versus “completely excised” basal cell carcinoma

    Plast Reconstr Surg

    (1968)
  • AC Thackray

    Histological classification of rodent ulcers and its bearing on their prognosis

    Br J Cancer

    (1951)
  • JR Sloane

    The value of typing basal cell carcinomas in predicting recurrence after surgical excision

    Br J Dermatol

    (1977)
  • GH Jacobs et al.

    Prediction of aggressive behavior in basal cell carcinoma

    Cancer

    (1982)
  • T Tozawa et al.

    Basal cell carcinoma with follicular differentiation

    Am J Dermatopathol

    (1987)
There are more references available in the full text version of this article.

Cited by (418)

  • Basal cell carcinoma

    2023, Ophthalmic Pathology: The Evolution of Modern Concepts
  • Correlation of basal cell carcinoma subtype with histologically confirmed subclinical extension during Mohs micrographic surgery: A prospective multicenter study

    2022, Journal of the American Academy of Dermatology
    Citation Excerpt :

    Histologically aggressive BCCs tend to be large, locally destructive, recurrent, or metastatic.18 In addition, they have been characterized as being more likely to exhibit positive tumor margins after surgical excision.6 During MMS, histologically aggressive subtypes require more stages to achieve tumor-free margins, most often due to peripheral (48.9%) rather than deep (11.7%) SCE.3

View all citing articles on Scopus
View full text