title: Metastatic basal cell carcinoma with squamous differentiation: report of a case with response of cutaneous metastases to electrochemotherapy.
abstract: BACKGROUND
  Metastatic basal cell carcinoma is a rare disease with poor prognosis. Palliative therapeutic approaches include surgery, radiotherapy, and/or chemotherapy. These treatment modalities are invasive and risky and associated with relevant adverse effects. Electrochemotherapy is a recently described therapy that relies on the permeation of cancer cell membranes by electrical pulses to enhance cytotoxic drug penetration. It has been successfully used in the treatment of primary and metastatic skin cancers. We report a case of metastatic basal cell carcinoma in which electrochemotherapy was effective in inducing local regression of skin metastases.
  
  
  METHODS
  A 75-year-old man presented with a pigmented, deeply infiltrating nodule in the right axilla manifesting as basal cell carcinoma with squamous differentiation at histopathologic examination. Despite 2 wide surgical resections involving lymphadenectomy with axillary vein substitution and systemic chemotherapy, a progressive metastatic spreading, both cutaneous and visceral, occurred in the following 2 years. Three successive sessions of electrochemotherapy with bleomycin sulfate were then performed on isolated skin metastases. The treatment was well tolerated and led to a rapid clinical and histologic regression of the treated lesions. Conclusion Electrochemotherapy is an effective and well-tolerated adjunct to the therapeutic options in metastatic basal cell carcinoma, characterized by an advantageous risk-benefit ratio and minimal downtime.
authors.affiliation: Clinica Dermatologica, University of Modena and Reggio Emilia, Modena, Italy. fantini.fabrizio@unimore.it
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Fantini
authors.forename: Giulio
authors.initials: G
authors.lastname: Gualdi
authors.forename: Augusto
authors.initials: A
authors.lastname: Cimitan
authors.forename: Alberto
authors.initials: A
authors.lastname: Giannetti
mesh_terms: D000368:Aged; D000903:Antibiotics, Antineoplastic / Q000627:therapeutic use; D001761:Bleomycin / Q000627:therapeutic use; D002280:Basal Cell Carcinoma / Q000188:drug therapy / Q000473:pathology* / Q000556:secondary*; D002454:Cell Differentiation; D053672:Electrochemotherapy; D006801:Humans; D008297:Male; D012878:Skin Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000556:secondary*; D016896:Treatment Outcome
chemical_list: D000903:Antibiotics, Antineoplastic; D001761:Bleomycin