Fact-sheet: Basal cell carcinoma
Updated on 09/27/2024 at 9:22 AM
View all RADEOS cases associated with this fact-sheet
Definition
Malignant, epithelial skin tumor arising from basal cells of the epidermis.
Clinical features
Most common skin tumor, especially in elderly patients and in sun-exposed areas.
Loco-regional progression that can be highly invasive and destructive to adjacent structures.
Pulmonary and bone metastatic spread is exceptional.
6 clinical forms: nodular, cystic, ulcerated, superficial, sclerodermiform, and pigmented and/or keratotic variants.
Generally no imaging, except in locally advanced or periorificial forms.
MRI
In locally advanced or periorificial forms.
Objectives:
- Identify clinically occult involvement
- Decide on possible neoadjuvant treatment
- Plan complete surgical excision.
Difficult to visualize on MRI:
- ulceration, tissue loss, very thin lesion
- minimal T2 hyperintensity, faint enhancement
- value of the T1 sequence+++, the lesion appearing hypointense relative to the underlying hypodermis
Useful in post-treatment follow-up to detect subclinical recurrence
Management
Superficial, non-periorificial forms: medical treatment.
Other forms: surgical treatment with slow-Mohs analysis for difficult locations or infiltrative forms.