BASAL CELL CARCINOMA

It is also known as RODENT ULCER. It is of low grade malignancy. It is liable to occur in fairly & dry skinned people constantly exposed to sunlight. It has no metastasis so it also k/as BENIGN CARCINOMA. Most common sites are:Middle third of face around inner & outer canthus of eye,nose,nasolabial fold.

ETIOLOGY:Ultraviolet radiation present in sunlight is considered as main etiological factor. Other predisposing factors are:1. Ionizing radiation 2. Burn scar 3. Other scars 4. Many types of chemicals 5. Atrophy associated with ageing.

 Elderly are usually affected. It affects males more than females. Fair skinned than darker skinned. CLINICAL FEATURES:It usually begin as a slightly elevated papule which may ulcerate,heals & break down again. It is not painful in beginning though it may etch. It is slow growing.

If untreated becomes big & deep. The ulcer is deeply eroding ulcer. It has typically rolled edge Floor shows scabbing over one area & break over other areas. It may cause pain or bleeding & may become infected. It is never seen in oral cavity unless it arive there by invasion & infiltration from a skin surface.

 HISTOLOGICAL FEATURES:In general the disease is characterised by the appearance of nest,islands or sheets of cells with large hyperchromatic nuclei. It may contain variable number of mitotic figures. The periphery of cell nest is composed of layer of cell usually well polarised. The variants are:Adenoid basal cell carcinoma represent that neoplasm which mimic glandular formation.

Cystic basal cell carcinoma is one which shows presence of cysts within lesion. Keratotic basal cell carcinoma refers to formation of parakeratotic cells. Solid or primodial basal cell carcinoma is one in which cells have little tendency to differentiate.

TREATMENT:Superficial radiotherapy cures over 90% of basal cell carcinoma. Surgical excision of the lesion along with healthy tissue margin at the circumference & at depth can be performed.