Abstract
AbstractThirty‐three horror basal cell carcinomas (18 large, six destructive, five locally uncontrollable, and four metastatic) were studied in detail. In comparison with a series of non‐horror cases, it was found that there were more horror cases in men and that the age of onset of horror tumors was earlier. The anatomical site was the same. Basic etiological factors included habitual sun exposure in 13, mustard gas burns in two, and one each of radioermatitis, trivalent arsenic ingestion and naevoid basal cell carcinoma syndrome. Fifteen had no obvious cause. It could not be shown that initial treatment with radiotherapy caused any change in the biological nature of the cancer. In 17 cases no medical treatment was sought until after the cancer had been present for over five years. It is concluded that these rare cancers, histologically indistinguishable from the ordinary basal cell carcinoma, are, from their onset, either biologically more aggressive or occur in patients with a lower tumor host resistance. Unfortunately apart from their bizarre biological behavior, we do not have any means of distinguishing them at their onset from the usual basal cell carcinoma.
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