Basal Cell Carcinoma’s are generally harmless skin cancers and do not spread anywhere else or kill people. They can grow to a big size locally, and even destroy bone if left untreated. Therefore treatment of the cancer (with either creams/ PDT or surgery, as appropriate) is recommended.
However, in rare cases like the one described by the authors below, they can spread to other places and even kill people. This is thankfully extremely rare and there are only a handful of cases (out of millions of BCC’s that occur every year) reported in the world. For practical purposes, these extremely rare instances can be ignored.
Am J Dermatopathol. 2012 Nov 8. [Epub ahead of print]
Case of Metastatic Basal Cell Carcinoma to Bone Marrow, Resulting in Myelophthisic Anemia.
Source
*Division of Dermatology and Cutaneous Surgery, University of Texas Health Science Center at San Antonio, San Antonio, TX †Department of Pathology, Audie L. Murphy VA Medical Center, San Antonio, TX ‡Division of Dermatology, Audie L. Murphy VA Medical Center, San Antonio, TX.
Abstract
BACKGROUND:: While basal cell carcinoma (BCC) remains the most common skin cancer, the incidence of metastasis is rare. Most cases of metastatic BCC have been to regional lymph nodes. Metastasis to bone marrow with myelophthisic anemia is especially rare. To our knowledge, there have been only 5 reported cases in literature. We report a sixth case. OBSERVATIONS:: A 46-year-old male patient presented with an 8 × 7-cm ulcerated plaque on his chest, found to be morpheaform basal cell on pathology. Laboratory findings were notable for normocytic anemia, thrombocytopenia, and elevated LDH. Further work up with bone marrow biopsy revealed tumor cells staining positive for CK AE1/AE3, BerEP4, CK7, CD56, and PIN-4. This confirmed the diagnosis of metastatic BCC (MBCC) to bone marrow. CONCLUSIONS:: Although the rate of metastasis for BCC is rare, once it occurs, prognosis is poor. MBCC remains a challenge to treat. Therefore, it is critical to resolve the primary BCC and obtain vigilant follow-up, especially in patients with multiple risk factors for MBCC.