title: Basal cell carcinoma with pulmonary and lymph node metastasis causing death.
abstract: BACKGROUND
  The incidence of metastatic basal cell carcinoma ranges from 0.003% to 0.55%. The 230 reported cases most often occurred in long-standing recurrent lesions and appeared in regional nodes or the lungs.
  
  
  METHODS
  The stromal dependence of the tumor provides an explanation for the nonmetastasizing nature of basal cell carcinoma. The dense fibrous stroma of the lymph node in the case of metastatic basal cell carcinoma reported in the present study is similar to other reported cases with metastases to lymph nodes, bone, bone marrow, glands, and subcutaneous tissue.
  
  
  CONCLUSIONS
  This metastatic basal cell carcinoma demonstrated lymphatic and hematogenous dissemination to the lungs and lymph nodes. A dense accumulation of microvessels was present at the boundary of the tumor nests and dermal stroma and in the stroma surrounding the tumor in the lymph node.
authors.affiliation: Departments of Medicine and Pathology, Division of Dermatology, Cardinal Bernardin Cancer Center, Loyola University Stritch School of Medicine, 2160 S First Avenue, Rm 341, Maywood, IL 60153, USA. jrobin5@lumc.edu
authors.forename: June K
authors.initials: JK
authors.lastname: Robinson
authors.forename: Madhu
authors.initials: M
authors.lastname: Dahiya
mesh_terms: D002280:Basal Cell Carcinoma / Q000556:secondary*; D017809:Fatal Outcome; D006801:Humans; D008175:Lung Neoplasms / Q000556:secondary*; D008207:Lymphatic Metastasis / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012878:Skin Neoplasms / Q000473:pathology*