Metastatic basal cell carcinoma to the bone and bone marrow.
BACKGROUND
Basal cell carcinoma (BCC) is the most common carcinoma in the community, but the incidence of metastatic events is exceedingly low. The few reported cases most often appear in regional nodes or the lungs, and patients usually exhibit multiple concurrent organs of spread at the time of diagnosis.


METHODS
We report a case of primary BCC located on the left forehead of a 48-year-old man, which metastasized exclusively to the bone and bone marrow, associated with hematologic disorders. A short review of the literature is included.


RESULTS
Pathologic examination of the tumor located on the left forehead showed BCC. The patient underwent two surgical excisions because of local recurrence. Three years later, the patient developed a bicytopenia (anemia and thrombocytopenia). The bone marrow biopsy revealed metastasis of BCC. There were no abnormal findings in the other routine laboratory tests and radiologic investigations, except for the bone scan which showed multifocal skeletal metastases. The patient received two cycles of chemotherapy with cisplatin 75 mg/m(2) before he died as a result of hemorrhagic complications and progressive disease.


CONCLUSIONS
Metastasis of BCC is a very rare condition that should not be overlooked. The prognosis remains very poor. We emphasize the importance of long-term follow-up of such patients.
Department of Medical Oncology and Pathology, National Institute of Oncology, Department of Plastic Surgery and Burns, Military Instruction Hospital Mohammed V, Rabat, Morocco. i_elghissassi@hotmail.com
Ibrahim
I
Elghissassi
Asmaa
A
Mikou
Hanane
H
Inrhaoun
Amine
A
Ennouhi
Lamiae
L
Gamra
Hassan
H
Errihani
D000740:Anemia / Q000209:etiology; D000970:Antineoplastic Agents / Q000627:therapeutic use; D019046:Bone Marrow Neoplasms / Q000188:drug therapy / Q000556:secondary*; D001859:Bone Neoplasms / Q000188:drug therapy / Q000556:secondary*; D002280:Basal Cell Carcinoma / Q000473:pathology* / Q000556:secondary* / Q000628:therapy; D002945:Cisplatin / Q000627:therapeutic use; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D008875:Middle Aged; D012878:Skin Neoplasms / Q000473:pathology* / Q000601:surgery; D013921:Thrombocytopenia / Q000209:etiology
D000970:Antineoplastic Agents; D002945:Cisplatin