Author/Authors :
Nahidi, Yalda Department of Dermatology - Cutaneous Leishmaniasis Research Center - Mashhad University of Medical Sciences - Mashhad, Iran , Tayyebi Meibodi, Naser Mashhad University of Medical Sciences - Mashhad, Iran , Esmaeili, Habiballah Department of Social Sciences - Faculty of Health - Mashhad University of Medical Sciences - Mashhad, Iran , Tafazzoli, Zahra Department of Dermatology - Cutaneous Leishmaniasis Research Center - Mashhad University of Medical Sciences - Mashhad, Iran
Abstract :
Background: Basal cell carcinoma (BCC) is the most common type
of skin tumor. Surgical removal has remained the gold standard
of treatment for BCC, but incomplete removal is an important
clinical challenge. The goal of our study was to evaluate the
incomplete excision of BCC and the factors affecting it.
Methods: In this retrospective study, 361 histological samples of
BCC excisions referred to the Pathology Department of Imam Reza
Hospital, Mashhad, Iran, from 2004 to 2018 were reviewed. Data
including age, gender, tumor site, size, histopathologic subtype,
surgical margin involvement, and the surgeon’s specialty were
recorded.
Results: The incomplete removal rate was 20%. Ten percent
of the lesions had deep margin involvement, 5.8% had lateral
margin involvement, and both margins were involved in 4.2%
of cases. Incomplete excision had a significant relationship with
the following variables: nodular, mixed, and sclerosing types;
the 60-70 years age group; lesions larger than 2 cm, location
in nose and canthi; and excision by an otorhinolaryngologist,
ophthalmologist, or dermatologist.
Conclusion: In this study, the frequency of incomplete excision
was relatively high compared with other studies. Therefore, it
is suggested to perform a diagnostic biopsy before the complete
excision of BCC. Excision with a wider margin or using Mohs
surgery is recommended for midface lesions, older individuals,
nodular, mixed, or sclerosing lesions, and for tumors larger
than 2 cm.
