Polypoid Basal cell carcinoma on the perianal region: a case report and review of the literature

Perianal Basal Cell Carcinoma-A Systematic Review and Meta-Analysis of Real-World Data

(1) Background: BCC is a sporadic disease that develops in areas of the skin not exposed to the sun. Perianal BCC, which occurs in the anorectal region, accounts for less than 0.2% of all BCC cases. There have been only a few reported cases of the disease, with fewer than 200 cases reported in total. Given the diagnostic challenges and potential for misdiagnosis, we conducted a systematic review of perianal basal cell carcinoma using real-world data to provide comprehensive and detailed information on the disease. (2) Methods: The study was reported based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, 2020. Patients' clinical pathologic features, tumor characteristics, treatment modalities, and outcomes were presented. (3) Results: The results of 41 studies involving 140 patients were analyzed. The most common symptoms reported by patients at presentation were anorectal bleeding, pain, and pruritus. Ulceration was the most frequently observed tumor characteristic. The majority of patients underwent local excision as their primary treatment, with only eight patients experiencing a recurrence. Our analysis did not reveal any statistically significant differences in the outcomes of different treatment modalities. (4) Conclusions: Identifying perianal BCC poses a significant challenge as it closely resembles other anal diseases, thereby making it difficult to differentiate between the different conditions. However, a wide local excision with clear margins is considered an effective treatment option for most patients. Alternative treatments, such as radiotherapy, may be recommended for patients who are unable to undergo surgery.

A Case Report of Basal Cell Carcinoma in a Non-Sun-Exposed Area: A Rare Presentation Mimicking Recurrent Perianal Abscess

Basal cell carcinoma (BCC), a common malignancy, arises most often in sun-exposed areas but does rarely occur in non-sun-exposed sites. Prior tissue injury, especially sharp trauma and chronic inflammation, increases the risk of BCC. We describe a 66-year-old male patient with recurrent perianal abscesses who was found to have a large pigmented basal cell carcinoma. The mass was excised without recurrence at two-year follow-up. Perianal BCC is commonly larger at the time of diagnosis than tumors in sun-exposed sites, likely related to delay in diagnosis. Increased size can lead to increased surgical complexity and more pronounced effects on nearby structures. Early detection is important for optimal patient outcomes. In selected patients presenting with a perianal mass, basal cell carcinoma should be included on the differential diagnosis.

Dermoscopy and reflectance confocal microscopy in pedunculated basal cell carcinoma

There have been limited cases of pedunculated basal cell carcinoma (BCC) reported in the literature. The dermoscopic features were described in only one of them. However, not one of them described the confocal microscopy features. In this report we presented a case of pedunculated basal cell carcinoma (BCC) with dermoscopic and reflectance confocal microscopy features.

Basal cell carcinoma mimicking pilonidal sinus: A case report with literature review

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Basal cell carcinoma (BCC) is the most common malignancy of the sun-exposed area. About 80–85% occur on the head and neck [2] (Lorenzini et al., 2005). It occur rarely in the other area.

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On the other hand, Pilonidal sinus (PNS) is a common benign disease that accounts for almost 15% of anal suppurations.

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We report a case of BCC presented with signs and symptoms of PNS.

Introduction

Pilonidal sinus is a common benign disease that accounts for almost 15% of anal suppurations while basal cell carcinoma is the most common malignancy of the sun-exposed area occurring mainly on the head and neck. We report a case of basal cell carcinoma presented with signs and symptoms of PNS. A 40-year-old male presented with swelling of the lower back for 2 years. On examination, there was a round, mobile, soft 4 × 2.5 cm mass on the sacrococcygeal area. Ultrasound showed subcutaneous cystic lesion. Clinical diagnosis of PNS was done and excisional biopsy was performed under local anesthesia. The result of the histopathological examination was suggestive for basal cell carcinoma.

Conclusion

Basal cell carcinoma should not be forgotten in differential diagnosis of superficial mass and abscesses.

Fibroepithelioma of Pinkus Revisited

Background

Fibroepithelioma of Pinkus (FeP) is considered a variant of basal cell carcinoma (BCC); however, in the past 20 years, some researchers have argued for its classification as a trichoblastoma. Recently, use of a new immunostaining marker and further dermoscopic characterization of FeP have advanced the debate about its proper classification.

Purpose

A review of the evidence for and against classification of FeP as BCC or trichoblastoma is presented.

Methods

Using PubMed, the term FeP was searched and relevant citations were assessed. Additional relevant articles were identified from references of key papers.

Results

FeP shares characteristics of both trichoblastoma and BCC.

Conclusion

Derived from the same cell type, BCC and trichoblastoma may be best considered as representing opposite ends of a spectrum of differentiation, with FeP deserving an intermediate classification.

[Polypoid basal cell carcinoma]

The basal cell carcinoma is a malignant tumor which originates from the epidermal stem cells. The polypoid basal cell carcinoma is an uncommon variant. We report on a 70-year-old man with a red nodule on his left breast. Clinical and histopathologic criteria led to the diagnosis of polypoid basal cell carcinoma. This variant is characterized by exophytic, polypoid growth. Histologically, the aggregates of tumor cells are usually limited to the polypoid zone.

Perianal Basal cell carcinoma-an unusual site of occurrence

Basal cell carcinoma is the most common nonmelanoma skin cancer. Its occurrence in the perianal region is very rare. Awareness of its benign behavior in this region, in contrast to the earlier reports, is vital in its management. Local excision seems to provide adequate control. We are herewith reporting an extremely rare case of a 69-year-old male with basal cell carcinoma treated adequately with local excision.

[Basal cell carcinoma. Molecular genetics and unusual clinical features]

Basal cell carcinoma is the most common human cancer. Its incidence is steadily increasing. The development of basal cell carcinoma is linked to genetic factors, including the individual skin phototype, as well as the cumulative exposure to UVB. The vast majority of basal cell carcinomas are sporadic tumors, while familial cases associated with certain hereditary syndromes are less common. At the molecular level, basal cell carcinomas are characterized by aberrant activation of sonic hedgehog signaling, usually due to mutations either in the ptch or smoh genes. In addition, about half of the cases carry mutations in the tp53 tumor suppressor gene, which are often UVB-associated C-->T transition mutations. Clinically, basal cell carcinomas may show a high degree of phenotypical variability. In particular, tumors occurring in atypical locations, showing an unusual clinical appearance, or imitating other skin diseases may cause diagnostic problems. This review article summarizes the current state of the art concerning the etiology, predisposition and molecular genetics of basal cell carcinoma. In addition, examples of unusual clinical manifestations are illustrated.

Multiple polypoid basal cell carcinomas on the perineum of a patient with basal cell nevus syndrome

We present a case report of a patient with basal cell nevus syndrome (BCNS) who developed multiple polypoid basal cell carcinomas (PBCC) in the perineum. PBCC is a rare variant of nodular BCCs. Clinically, PBCCs mimic acrochordons. We recommend that the perineum, perianal, and genital areas should be included in the routine exam of patients with BCNS.