Carcinoma basocelular: fatores de risco de recorrência e o laudo histopatológico

Abstract

Basal cell carcinoma (BCC) is the most common malignant neoplasm in Brazil, representing approximately 80% of skin cancers. Although the metastatic potential of this neoplasm is very low, some subtypes have a high risk of recurrence (micronodular, infiltrative, sclerodermiform, basosquamous). Clinical and histopathological data provide important information regarding the potential for lesion recurrence, which determines the primary treatment and the institution of additional treatments. This study aimed to analyze cases of BCC diagnosed and treated at the Clementino Fraga Filho University Hospital (HUCFF) in the first half of 2023. The research identified 178 cases diagnosed as BCC. Of these, 57 cases corresponding to excisional resections were selected, analyzed, and classified according to the risk stratification criteria of the National Comprehensive Cancer Network (NCCN). The mean age of the patients was 69.5 years, with a predominance of male cases, accounting for 67% of the total patients. The most frequent histological subtype of basal cell carcinoma was the nodular type. The face was the most common location for the lesions. Angiolymphatic invasion was not identified in any of the cases analyzed. Perineural infiltration, although rare, was observed in only one case. Infiltration beyond the reticular dermis was recorded in three cases. According to the risk stratification criteria defined by the NCCN, slightly more than half of the cases could be classified as high risk. There was a high level of agreement between the data obtained from the histopathological reports and the case review, and the relevant positive data (margin status, invasion depth) were declared in the vast majority of the cases, which reflects the good quality of the HUCFF/UFRJ SAP reports. Additionally, the data obtained were valuable for understanding the distribution and characteristics of basal cell carcinoma in the context of HUCFF, providing a relevant overview for the management and follow-up of patients with this condition.