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Basal Cell Carcinoma of the Head and Neck Region: A Retrospective Analysis of Completely Excised 331 Cases

DOI: 10.1155/2014/858636

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Abstract:

The aim of the study is to analyze all completely excised BCCs in the head and neck region with regard to age, sex, personal and familial history, skin type, tumor localization and size, histopathological subtype of tumor, reconstruction method, and recurrence rates. Incompletely excised BCCs were not included in this study since incomplete excision is the most important preventable risk factor for recurrence. In 320 patients, 331 lesions were retrospectively evaluated by dividing into the following 8 subunits: scalp, frontotemporal, orbital, nose, cheek, auricula, perioral, and chin-neck area. Most of the patients were in 60–70 age group (34.7%). The nose (32.3%) was the most common site of presentation. Clinically, all lesions and, histopathologically, most of the lesions (42.2%) presented were of the nodular type. All cases of recurrence after complete excision ( , 2.7%) were located in the median parts of the head and neck region and were mainly diagnosed histopathologically as sclerotic and micronodular. Even though completely excised, head and neck region BCCs, especially which are more prone to recurrence due to anatomical and histopathological properties, should be more closely monitored in order to decrease morbidity and health care costs. 1. Introduction Basal cell carcinoma (BCC) is the most common type of skin cancer in the head and neck region. The incidence of BCC is on the rise, and it represents approximately 65% of all skin carcinomas [1–3]. BCC is not usually life threatening, unlike malignant melanoma, but it is locally invasive and may lead to considerable morbidity and complications [4]. BCC is the most frequent tumor type among the US population and also has a strongly rising incidence in Europe. Although, the incidence of BCC in Turkey is not accurately known, we think that there is a rise in the number of patients who are admitted to medical facilities [2]. With the increase in the incidence of BCC, even though mortality is relatively low, the morbidity and treatment-related costs represent a significant burden to health care systems. Treatment options include medical and surgical modalities. The first therapy of choice is generally surgical excision, with safe surgical margins. Recurrence is more common, especially with positive peripheral margins and certain types of BCC, like morpheaform forms. Recurrent BCC tends to be biologically more aggressive than primary lesions [1]. Positive surgical margins in primary BCC excisions in the head and neck region were reported to be 3–20% in the literature [5]. Recurrence rates in

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