Factors involved in skin carcinogenesis

Management of Mucosal Basal Cell Carcinoma of the Lip: An Update and Comprehensive Review of the Literature

BACKGROUND

Basal cell carcinoma (BCC) is the most common malignancy in the United States. Most BCCs occur on cutaneous surfaces, but rare cases on the mucosal lip have also been documented. Because only a small number of mucosal BCC (mBCC) cases have been reported, data on their clinical characteristics and management are limited.

OBJECTIVE

To perform an updated literature review of the management of mBCCs on the lip.

METHODS

A comprehensive literature review was conducted through a search of the PubMed database with the key phrases "mucosal basal cell carcinoma," "basal cell carcinoma mucosa," and "basal cell carcinoma lip mucosa."

RESULTS

Forty-eight cases of mBCCs have been reported, and 35 had sufficient data for analysis. The average age at presentation was 66.8 years, and 57% (n = 20) had a history of skin cancer. Most cases were treated with surgical excision or Mohs micrographic surgery (MMS), with only 1 recurrence in the literature. Furthermore, the authors present 8 additional cases of mBCCs successfully treated with MMS.

CONCLUSION

Mucosal basal cell carcinomas are rare, and skin cancer history may be a risk factor. Because the lip is a cosmetically and functionally important area, MMS may be the preferred treatment method for mBCCs in this location.

Basal cell carcinoma of the vermilion zone of the lower lip: a report of 3 cases

Three cases of basal cell carcinomas (BCCs) of the vermilion zone of the lower lip are reported. The possible histopathogenesis of these BCCs is discussed. All lesions were treated by Mohs micrographic surgery.

Hereditary onset of multiple seborrheic keratoses: a variant of Leser Trélat sign?

A 79-year-old man in a cancer-prone family developed disseminated seborrheic keratoses over his trunk and extremities over a few decades without rapid increase. His son, mother, and one of his brothers, who died of gastric cancer, also had numerous seborrheic keratoses for a long time. He had a biliary tract cancer. Histologic examination showed hyperproliferation of basaloid cells branching downwards, as if induced by surrounding stroma. No decrease of the number of seborrheic keratoses after surgical operation has been observed. Examination for the localization of epidermal growth factor receptor (EGF-R) and HER-2/neu oncoprotein by immunohistochemistry revealed positive staining on the epithelial strands branching downwards on the specimens of seborrheic keratoses. A different pattern of expression was demonstrated in normal seborrheic keratosis. These findings suggest that some unidentified growth factors may be involved in the induction of visceral and/or cutaneous neoplasms in this family.

Isotretinoin-basal cell carcinoma prevention trial. Design, recruitment results, and baseline characteristics of the trial participants. The ISO-BCC Study Group

The Isotretinoin-Basal Cell Carcinoma Prevention Trial (ISO-BCC Study) is a double-masked, randomized, placebo controlled, multicenter clinical trial. It is the first intramural cancer chemoprevention trial sponsored by the Division of Cancer Prevention and Control of the National Cancer Institute. This trial was designed to evaluate the effectiveness of chronic administration of low dosage levels (10 mg) of a synthetic retinoid, isotretinoin, in reducing the incidence of basal cell carcinoma in a high-risk population and to determine the incidence and severity of side effects associated with this long-term treatment. Between 1984 and 1987, eight clinical centers enrolled 981 participants between the ages of 40 and 75, who had two or more biopsy proven basal cell carcinomas in the 5 years before trial entry. This article describes the trial design, recruitment results, and baseline characteristics of the participant population in the ISO-BCC Study.

Lectin-binding abnormalities in the stromal and epithelial components of basal cell carcinoma

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Hyaluronectin in normal human skin and in basal cell carcinoma

The localization of hyaluronectin has been studied in normal skin and in basal cell carcinoma. In fetal skin it is abundant in the dermis but absent from the epidermis, and in adult skin it is totally absent except in the hair sheaths and bulbs. In basal cell carcinoma it is abundant only in the stroma reaction. The presence of this protein in mesenchymatous tissues seems to be linked to zones of physiological or neoplastic proliferation.