A A Rare Case of a Metastatic Basal Cell Carcinoma

Background: Basal cell carcinomas are malignant slow-growing neoplasms of the epidermal layer of the skin. They are the most common form of skin cancer, accounting for 80% of non-melanoma skin cancers. Metastasis is rare with an incidence rate of 0.0028 to 0.55%. We report a case of an 83 year old male presenting with basal cell carcinoma (BCC) of the right cheek. The tumour was completely excised with close margins. The patient was closely monitored clinically and on follow-up, a mass in the region of the right parotid was identified. Excision of the tail of the right parotid identified a tumour with similar subtype to the primary tumour excised from the cheek confirming diagnosis of metastatic BCC. Methods: A literature search was carried out inclusive of the terms identify existing data and guidelines to determine best evidence based practice. Discussion: Literature search identified aetiology of BCCs and methods of diagnosis and treatment. The search also highlighted an incidence rate of 0.0028 to 0.55% and complications associated with metastasis. The patient underwent a course of radiotherapy as surgery in this case was contraindicated due to history of excision of the parotid tail. Risk factors for developing BCCs include intermittent sun exposure, ionising radiation, genetic predisposition and immunosuppression. Metastases occurs via the lymphatic system or haematogenously. Surgery is the main form of treatment and aims to be curative.