Basal cell carcinoma destructive C44.L

Primary destructive growing basal cell carcinoma. The term has become uncommon today as "infiltrating and destructive growth" is a characteristic feature of all basal cell carcinomas (see below).

Mainly Caucasian population, rarely in African countries, age at occurrence > 50 years.

Excessive exposure to UV rays. Also possible in immunocompromised patients (e.g. after stem cell transplantation).

all parts of the face, va. nose, forehead, cheeks

Mostly tub-like, large-area (1.0 - 5.0 cm, rarely > 5.0 cm), slightly painful, sharply defined, red ulcer with a raised, nodular rim wall. Musculature or bones may be exposed at the base of the ulcer.

Arrosion bleeding of larger vessels or osseous destruction with penetration into the skull calotte is possible.

Early, generous surgical removal in healthy individuals (micrographic surgery), see basal cell carcinoma.

Infiltrating and thus destructive growth is a characteristic feature of all basal cell carcinomas. With a longer duration of existence and increasing infiltration of deeper skin areas, the tumour first decays on its surface and successively also in deeper layers. With extensive horizontal growth, by "grazing" the surface, superficial, polycyclically limited ulcers develop, actually exulcerated basal cell carcinomas (ulcer roden).

When growing in depth, vital structures can be detected. This "drilling" type, also known as ulcus terebrans, can reach monstrous proportions after years of existence.

1. Sonntag M et al (2004) Ulcus terebrans. Therapy options and their limits. dermatologist 55:983-985