Outcomes of basal cell carcinomas directly invading the parotid gland.
BACKGROUND
Parotid involvement by basal cell carcinoma (BCC) is rare, and therefore management is controversial.


OBJECTIVE
To review the treatment and outcomes of patients with BCC involving the parotid by direct infiltration.


METHODS
The authors performed a retrospective chart review of BCC cases involving the parotid.


RESULTS
From 1994 to 2007, there were 19 cases of BCC involving the parotid gland by direct extension. Nine were primary tumors, and 10 recurrent (nonprimary). Eight tumors were treated with Mohs micrographic surgery (MMS), and 11 with wide local excision (WLE). One patient died of unrelated causes 5 months after treatment, and 2 did not follow up. The remaining 16 cases had an average follow-up of 55.2 months (range, 18-112 months). No primary BCC recurred after treatment. Six of 10 nonprimary BCC (60%) recurred, 2 of 10 metastasized, and 1 of 10 died of metastatic BCC. Two recurrences occurred after MMS, and 4 occurred after WLE with or without parotidectomy.


CONCLUSIONS
Mohs micrographic surgery or WLE with intra-operative margin control seems to be an acceptable first-line treatment for primary BCC involving the parotid. Recurrent BCC involving the parotid gland through direct infiltration has high rates of future recurrence, and adjuvant treatment may be required.
*Department of Dermatology, Mayo Clinic, Rochester, Minnesota; †Department of Dematology, Kaiser Permanente, Los Angeles, California.
Kevin N
KN
Christensen
Gregory P
GP
Henderson
Thomas L
TL
Hocker
Clark C
CC
Otley
Randall K
RK
Roenigk
D000368:Aged; D000369:Aged, 80 and over; D002280:Basal Cell Carcinoma / Q000473:pathology* / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015580:Mohs Surgery; D009361:Neoplasm Invasiveness / Q000473:pathology; D010307:Parotid Neoplasms / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000473:pathology* / Q000601:surgery*; D016896:Treatment Outcome