Basal cell carcinoma (BCC) is the most common malignant tumor of the skin. This study was conducted to analyze patients with BCC, their age and sex distribution, occupation, site distribution of tumors, clinical types, and histopathological characteristics of lesions. Based on the data obtained from the Histopathological Registry, a clinical and histopathological analysis of the surgically excised BCCs was performed.
The study included 100 randomly selected patients out of 263 consecutive patients with histopathologically diagnosed BCC at the Institute of Pathology of the Clinical Center in Niš in the period of 15 months. The sex ratio was 1.4:1 in favor of men (p<0.05). Two thirds of patients were over the age of 60 (p<0.0001). The average age of patients was 66.6 ± 12.2 years (range 23 - 90). In agreement with the age distribution, 53 patients were retired (mostly retired farmers), 12 were workers, 14 farmers, 12 without permanent employment, 5 were housewives, and 4 clerks. A substantial majority of 61% of examinees lived in the country (p<0.001). The employment status was related to the age of examinees, but also with the altered demographic structure in the country: many workers lived in the country, or returned to the country after retirement.
BCC was commonly found on the face (77%), and rarely on the trunk (11%) and extremities (2%).
There were no data about exposition to X-rays or chemicals (except for pesticides and insecticides), scars resulting from burns or genodermatoses. In 87% of cases, BCC was significantly most often found at sites continually exposed to the sun (head including face and scalp, and neck). The most commonly diagnosed was the nodular type (57%), then the superficial (7%), ulcerative (5%), ulcero-sclerotic (4%), pigmented (1%), and morpheaform (1%). In 27% of cases, there were no data about the histopathological type of BCC in the Histopathological Registry, based on which accurate histological type of BCC could have been established. Based on histopathological analysis, apart from the nodular (40%), other types were rarely diagnosed, like the adenoid (12%) (p<0.0001), mixed types (nodular-adenoid, nodular-adenoid-fibroblastic and mixed) (9%), superficial (7%), fibroblastic (2%), infiltrative (1%), pigmented (1%), and morpheaform (1%). Surgical excision is the gold standard in the treatment of BCC: conventional, conducted in our patients, and Mohs micrographic surgery, which takes an important place in the treatment of high-risk BCCs. In 6% of cases, the tumor process was found in the margins of the excision.
In conclusion: Basal cell carcinoma was more common in males than in females. Significantly more patients with excised basal cell carcinoma lived in the country. An age-related increase in the number of patients with BCC has been established, and most patients with excised basal cell carcinomas belonged to the age group of 61 to 81 years of age. In most patients the tumor site was on the face, whereas clinically and histopathologically, nodular type was the most common.