Perianal Basal Cell Carcinoma Research Articles

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.

Perianal basosquamous carcinoma treated with radiation therapy, a case report.

Perianal basal cell carcinoma (BCC) is very rare and estimated to account for 0.08% of all BCC and 0.02% of all anorectal neoplasms. Perianal lesions are more likely to be squamous cell carcinoma (SCC) as BCC usually develops on areas of skin exposed to ultraviolet (UV) light such as the face and arms. Proper diagnosis with the assistance of immunohistochemistry (IHC) stains to distinguish the two entities can help inform the suitable course of treatment. Our case is an 82-year-old male with a history of cutaneous BCC on the arms and trunk presenting with a symptomatic perianal lesion. Initial biopsy demonstrated BCC with subsequent IHC studies differentiating from basaloid SCC. Standard treatment includes wide local excision (WLE) but given his poor performance status, radiation only was recommended. He was successfully treated and tolerated 30 Gy in 5 daily fractions. Radiation only is a unique and feasible non-surgical treatment for basosquamous carcinoma of the anus.

Huge perianal basal cell carcinoma

Abstract Introduction: Basal cell carcinoma (BCC) is a common skin malignancy, but perianal BCC is rare and usually small. Here, we present a patient with a condyloma-like huge perianal BCC. Patient concerns: A 60-year-old Chinese man presented with a progressively growing perianal mass that had been growing for 8 years. The diameter of the perianal mass was ultimately up to 7 cm, accompanied by intermittent bleeding. Diagnosis: Histopathological evaluation of the punch biopsy specimen revealed BCC. Interventions: Total excision of the mass and transverse colostomy was performed. The postoperative pathological result was BCC, but part of the specimen's incisal margin was infiltrated by cancer. Therefore, after a month of recovery, local radiotherapy was started, and the wound healed completely. Stoma reversal was performed 4 months after the surgery. Outcomes: Postoperative anal function was satisfactory. The patient was asymptomatic and showed no signs of BCC recurrence one year after surgery. Conclusion: We present a case of isolated large perianal BCC in a patient with no known risk factor. As for huge perianal BCC, local wide resection is the preferred treatment. If the wound is large and close to the anus, transverse colostomy is needed. However, it is difficult to ensure a safe incisal margin because of the large size of the tumor; therefore, radiotherapy is also required.

A Case of Perianal Basal Cell Carcinoma in a Man over 90 Years of Age

A Case of Perianal Basal Cell Carcinoma in a Man over 90 Years of Age

Wide Excision and Posterior Thigh Flap Reconstruction for Perianal Basal Cell Carcinoma

Wide Excision and Posterior Thigh Flap Reconstruction for Perianal Basal Cell Carcinoma

肛門周囲皮膚に発生した稀な基底細胞癌の1例

73歳男性の肛門周囲皮膚に発生した基底細胞癌の1例を報告した．肛門部3時から9時の方向の両臀部に30×30mm，多少隆起した赤黒色の腫瘍を認めた．生検にて充実型の基底細胞癌の診断を得，皮膚面で7mm，粘膜面で5mm離し，脂肪層で切除した．1.5倍のメッシュ状にした12/1,000 inchの皮膚をtie-over固定で植皮した．術後1年の現在，再発や運動障害・排便障害などはない．鑑別診断として，より悪性度の高い類基底細胞癌があげられる．本邦で行われていないMohs micrographic surgeryと米国NCCN（National Comprehensive Cancer Network）のclinical practice guidelinesにも言及した．

Basosquamous Cell Carcinoma of the Anus

Cancer of the anus is a rare neoplasm in the general population and accounts for only about 1.2–2 % of gastrointestinal cancers [1–3]. Anal carcinoma usually appears in the fifth and sixth decades of life and shows a female predominance [1–3]. Regarding anatomy, anal carcinomas are divided into those occurring within the anal canal and those occurring at the anal verge [1]. The most common malignant anal tumor is squamous cell carcinoma and its variants whereas other more rare lesions include adenocarcinoma, small cell carcinoma, undifferentiated carcinoma, melanoma, lymphoma sarcoma, and perianal basal cell carcinoma [1–3]. Basal cell carcinoma is a very rare anal tumor of the anal margin representing only 0.2 % of the anorectal tumors [1, 4] and with only a few more than a hundred cases having been reported [5]. Clinically, the cancer presents usually as a slowly growing sharply marginated area with raised edges and central ulceration which can extend into the anal canal to the squamous zone [3–5]. We present a very rare case of basosquamous carcinoma of the anus and emphasize this rare aggressive variant of basal cell carcinoma and its differential diagnosis from basaloid carcinoma an aggressive variant of squamous cell carcinoma.

Reconstruction for basal cell carcinoma in an anatomical region where the sun does not shine: an attractive option!

Basal cell carcinoma is one of the common skin malignancies but it is rarely found in sun-protected areas. The soft tissue reconstruction at the perianal region can be challenging and a variety of options are described in the literature. The keystone design perforator island flap is an excellent and attractive option for soft tissue reconstruction. We present a case of perianal basal cell carcinoma that was reconstructed with a unilateral keystone flap.

Perianal basal cell carcinoma – unusual localization of a frequent tumor

Basal cell carcinoma is the most common human neoplasia. In more than 80% of patients, who are predominantly elderly, it is located in the head-and-neck-area. Basal cell carcinomas in non-UV-exposed areas of the body, such as the anogenital region, are dermatological rarities. We describe an 88-year-old patient with a perianal tumor that was detected during skin cancer screening. Histopathology showed the tumor to be a basal cell carcinoma. Immunohistochemical staining for Ber-EP4 was highly positive, clearly distinguishing the tumor from basaloid anal carcinoma, which is the most important histological differential diagnosis. Additional virological analyses for human papil-lomaviruses (HPV) were negative. Immunohistochemical staining for p16(INK4a) demonstrated strong expression in the cells of the tumor parenchyma. However, p16(INK4a) can also be expressed independently of HPV. The present case shows that all uncertain perianal skin lesions should be biopsied.

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.

Carcinoma basocelular perianal: relato de caso e revisão da literatura

O Carcinoma basocelular (CBC) é a mais freqüente das neoplasias epiteliais, localizando-se preferencialmente em áreas expostas ao sol. A ocorrência deste tumor na região perianal é extremamente rara. Neste artigo, relatamos um caso de CBC perianal. Apresentamos também uma revisão da literatura médica sobre o tema, salientando as características clínicas e histopatológicas, bem como o tratamento preconizado para esse tipo de tumor.

Perianal Basal Cell Carcinoma

Background: A case of basal cell carcinoma (BCC) of the perianal region is reported. This tumor is extremely rare in this location and behaves rather innocently. Objective: Clinical and histopathologic characteristics of perianal BCC, as well as the choices of treatment, are outlined. Conclusion: The tumor should be histologically distinguished from basaloid carcinoma of the anus, which is much more aggressive and metastasizes early, thus requiring a different therapy.

Perianal and genital basal cell carcinoma: A clinicopathologic review of 51 cases

Background: Basal cell carcinoma (BCC) occurring on non-sun-exposed sites, especially the perianal and genital regions, is very rare. Objective: We analyzed the incidence, clinical and pathologic features, and etiologic and prognostic factors of all non-nevoid perianal and genital BCCs diagnosed at our institution within a defined period (January 1985-September 1996). Methods: A retrospective review was performed with the use of patient clinical records and dermatopathologic slides. Cutaneous biopsy samples were tested for the presence of human papillomavirus (HPV) by in situ hybridization using biotinylated pan-HPV and serotype-specific (6, 11, 16, 18, 31, 33, 51) probes. Results: Of all non-nevoid BCC syndrome cases, 51 BCCs (0.27%) were located within the perianal and genital regions. The average age of the patients was 73 years. Nine perianal BCCs occurred in men, 6 in women. Ten BCCs occurred in the pubic area, 18 on the vulva, 6 on the scrotum, and 2 on the penis. Three patients had 2 tumor sites. The average size of BCC was 1.95 cm; 29.4% were ulcerated. Seventeen patients (36%) had a history of skin cancer on sun-exposed sites and 10 (21%) had a possibly relevant associated condition. HPV was not detected in the specimens tested. Treatments included wide excision (n = 32), electrodesiccation and curettage (n = 10), Mohs micrographic surgery (n = 8), and carbon dioxide laser (n = 1). Of 30 patients with 5 years' follow-up or longer, 1 recurrence was noted 7 years after wide excision. There were no metastases. Conclusion: BCC of the perianal and genital skin is rare and exhibits clinical and histologic heterogeneity. Advancing age and local trauma may contribute to the pathogenesis of BCC at these sites. (J Am Acad Dermatol 2001;45:68-71.)

Basal cell carcinoma of the perianal region: 20-year experience.

Although basal cell carcinoma remains the most common cutaneous malignancy, its occurrence in the perianal region is very rare. Earlier reports have suggested that basal cell carcinoma in this region may be more aggressive than basal cell carcinoma in other regions of the body. A chart review of patients with perianal basal cell carcinoma who presented consecutively during a 20-year period (ending December 1996) was performed. Patients included were those with a histologically proven diagnosis of basal cell carcinoma in the perianal region. Twenty-one cases were identified (15 male) with a mean age at diagnosis of 67 (range, 43-81) years. Follow-up data were available on 19 patients with a mean follow-up time of 72 (range, 2-214) months. Seventeen patients were treated by local excision, one by electrocautery, and one by Moh's surgery. No patients developed a local recurrence. Seven patients (33 percent) had multiple basal cell carcinomas at other anatomic sites. Four patients died of other causes during the follow-up period. Perianal basal cell carcinoma is a rare tumor. Given the significant association with multiple lesions at other sites, a diagnosis of perianal basal cell carcinoma should prompt an examination of all cutaneous surfaces. It does not seem to be more aggressive in this region than in other areas. Local excision seems to provide adequate control.

Complications of absorbable pelvic mesh slings following surgery for rectal carcinoma.

To evaluate the intraoperative, postoperative, and long-term complications of an absorbable pelvic mesh sling after surgery for rectal carcinoma. A retrospective review of medical records from April 8, 1991, through April 8, 1996. Twenty patients with a mean age of 57 (range, 37-79) years underwent pelvic mesh sling placement. The tumor stages were as follows: Stage I, 5; Stage II, 2; Stage III, 11; and Stage IV, 1. A recurrent perianal basal cell carcinoma was not included in the staging group. Surgery consisted of 18 abdominoperineal resections, 1 total proctocolectomy, and one Hartmann's procedure. Mean follow-up was 18 (range, 2-49) months. There were no intraoperative complications related to mesh placement. Twenty-nine complications occurred in 14 patients during the immediate postoperative period. Five were possibly mesh-related and included a pelvic abscess, perineal seroma, toxic perineal wound, pulmonary embolus, and lower extremity deep venous thrombosis, respectively. A mild postoperative ileus developed in 17 patients (85 percent), and a diet was initiated at a mean of seven (range, 4-24) days. Fourteen patients received postoperative radiotherapy with a mean dose of 5,339 (range, 2,500-7,020) cGy delivered in 180-cGy fractions. There were 14 immediate complications caused by radiotherapy in 11 patients, but only two patients required delays in treatment. Two patients had diarrhea alone, six developed perineal dermatitis alone, and three patients had both diarrhea and perineal dermatitis. All patients with diarrhea had received chemoradiation. One patient developed a partial small-bowel obstruction following radiation. Absorbable pelvic mesh sling placement can be performed with minimum morbidity and is recommended following surgery for rectal cancer when radiation is anticipated as part of multimodality therapy.

Basal cell carcinoma in North American blacks: Clinical and histopathologic study of 26 patients

Basal cell carcinoma is rare in blacks. A clinical and histopathologic review of 43 basal cell carcinomas in 26 black patients is reported. Basal cell carcinoma was found to be more common in women than in men. Our data indicated a lower prevalence on the nose and trunk compared with other reports. Multiple tumors were more common in our series. Our study included the youngest black patient with a pure basal cell carcinoma, the first reported superficial basal cell carcinoma, the second reported perianal basal cell carcinoma, and one albino patient with 12 tumors. Histologically there was a positive correlation between the maximum depth of tumor invasion and the maximum diameter of the lesion. Of three basal cell carcinomas arising in scars, metastasis developed in one. Our report includes a review of basal cell carcinomas in North American blacks.