Basal cell carcinoma (BCC) is the most common form of skin cancer. The hallmarks of this carcinoma are the absence of distant metastases and local malignancy. Metatypical basal cell carcinoma (MTBBC) is rare variant that it is considered to be a more aggressive form, with a higher potential for metastases and recurrence. Probably due to its very rare occurrence, data on pathogenesis, course and treatment are inconsistent.

Case report:
An unusual and very aggressive course of MTBBC with multiple metastases is prtesented. Repeated histopathological evaluation shows the diagnostic difficulties in this type of tumour. Therapeutic attempts, including targeted therapy with vismodegib, were unsuccessful.

This case showed that it should always be taken into account that each case of diagnosed BCC may turn out to be metatypical variant with a much more aggressive course and worse prognosis. For this reason, intensive follow-up after a completed treatment is recommended.

Rutkowski P. Owczarek, W. Guidelines for diagnostic and therapeutic management: skin carcinomas. Oncol Clin Pract. 2018; 14(3): 129–147.
De Giorgi V, Savarese I, Gori A, et al. Advanced basal cell carcinoma: when a good drug is not enough. J Dermatolog Treat. 2020; 31(6): 552–553.
Castanheira A, Boaventura P, Pais Clemente M, et al. Head and neck cutaneous basal cell carcinoma: what should the otorhinolaryngology head and neck surgeon care about? Acta Otorhinolaryngol Ital. 2020; 40(1): 5–18.
Chinem VP, Miot HA. Epidemiology of basal cell carcinoma. An Bras Dermatol. 2011; 86(2): 292–305.
Lomas A, Leonardi-Bee J, Bath-Hextall F. A systematic review of worldwide incidence of nonmelanoma skin cancer. Br J Dermatol. 2012; 166(5): 1069–80. 10.1111/j.1365-2133.2012.10830.x.
Mori S, Cordova M, Nehal KS, et al. Basal cell carcinoma: Epidemiology; pathophysiology; clinical and histological subtypes; and disease associations. J Am Acad Dermatol. 2019; 80(2): 303–317.
Richmond-Sinclair NM, Pandeya N, Ware RS, et al. Incidence of basal cell carcinoma multiplicity and detailed anatomic distribution: longitudinal study of an Australian population. J Invest Dermatol. 2009; 129(2): 323–8.
Sánchez G, Nova J, Rodriguez-Hernandez AE, et al. Sun protection for preventing basal cell and squamous cell skin cancers. Cochrane Database Syst Rev. 2016; 7(7): CD011161.
Stern RS. PUVA Follow-Up Study. The risk of squamous cell and basal cell cancer associated with psoralen and ultraviolet A therapy: a 30-year prospective study. J Am Acad Dermatol. 2012; 66(4): 553–62.
Rutkowski P, Jassem J, Krzakowski M. Złośliwe nowotwory skóry. 2nd edition. Gdańsk: ViaMedica; 2014.
Berking C, Hauschild A, Kölbl O, et al. Basal cell carcinoma-treatments for the commonest skin cancer. Dtsch Arztebl Int. 2014; 111(22): 389–95.
Saadani CH, Baybay H, ElMahi H, et al. Basosquamous Carcinoma: Report of Two Cases and Review of Literature. Int J Cancer Clin Res. 2018; 5(1): 093.
Tchernev G, Ananiev J, Cardoso JC, et al. Metatypical Basal cell carcinomas: a successful surgical approach to two cases with different tumor locations. Maedica (Bucur). 2014; 9(1): 79–82.
McCusker M, Basset-Seguin N, Dummer R, et al. Metastatic basal cell carcinoma: prognosis dependent on anatomic site and spread of disease. Eur J Cancer. 2014; 50(4): 774–83.
Rutkowski P, Owczarek W. Biblioteka Chirurga Onkologa. Dermatochirurgia. Gdańsk: Via Medica; 2018. p. 12.
Tarallo M, Cigna E, Frati R, et al. Metatypical basal cell carcinoma: a clinical review. J Exp Clin Cancer Res. 2008; 27(1): 65.
Frampton JE, Basset-Séguin N. Vismodegib: A Review in Advanced Basal Cell Carcinoma. Drugs. 2018; 78(11): 1145–1156.
Shukla S, Khachemoune A. Reappraising basosquamous carcinoma: a summary of histologic features, diagnosis, and treatment. Arch Dermatol Res. 2020; 312(9): 605–609.
Journals System - logo
Scroll to top