Path - BCC Flashcards
Describe a BCC
https://www.nice.org.uk/guidance/csg8/evidence/2010-update-the-management-of-lowrisk-basal-cell-carcinomas-in-the-community-updated-recommendations-and-evidence-on-this-topic-only-pdf-7022614429
Slow-growing, locally invasive malignant epidermal skin tumour
More common caucasians
Causes of erythema
In BCC - Telangiectasia Target Lesions Erythema Multiform Infection Drug reactions Liver disease Thyrotoxicosis Sun burn Vasculitis
Differential Diagnoses
Nodular BCC
Pigmented melanoma
Pyogenic Granuloma
Haemtoma
How do tumours spread
BCC - Metastases are rare
SCC - Regional Lymph nodes
Intraoperative investigations
Intraoperative histological examination of surgical margins
Pathology report - owl eye sign
Of an entire nucleus - Reed sternbern cells in Hodgekins Lymphoma
Or smaller Inclusion bodies - CMV infection
Reed sternbern cells
https://medivizor.com/blog/tag/reed-sternberg-cells/
Treatment
https://www.bad.org.uk/library-media/documents/BCC_2008.pdf
Superficial - medical maybe better - topically immunotherapy imiquimod
Surgical Excision is gold standard - recurrence rate <2% in 5 years
- 3-mm peripheral surgical margin will clear the
tumour in 85% of cases.
- 4–5-mm peripheral margin will
increase the peripheral clearance rate to approximately 95%,
Near the eye - MOHS Micrographic surgery
Radiotherapy for advanced or non-operable tumours and in recurrence (also 5-10mm EXCISION)
Types of BCC - PINCUMS
PINCUBS
- Pigmented
- Infiltrative / Morpheic
- Nodular
- Cystic
- Ulcerating
- Basosquamous
- Superficial
Management of BCC
Early stages and low risk tumours - curettaged, cryotherapy, radiotherapy and photodynamic therapy.
Indication for Moh’s
- Central face - eyes, nose, lips and ears
- Tumour is greater than 2 cm
- Poor clinical definition of tumour margins
- Recurrent lesions
- Perineural or perivascular involvement
