Morpheaform Basal Cell Carcinoma

Morpheaform basal cell carcinoma (BCC), also called as sclerosing BCC is a rare variant of basal cell carcinoma with more aggressive characteristics and atypical clinical presentation. The vast majority of basal cell carcinomas are nodular or superficial. Morpheaform basal cell carcinoma is considered a potentially more aggressive subtype

Causes of Morpheaform Basal Cell Carcinoma

The exact cause still remains unexplained, but genetic and environmental factors are believed to be predisposing factors for mBCC. Researchers suggest that ultraviolet rays from the sun may play an important role in genetic mutation.

Clinical features of Morpheaform basal cell carcinoma

MBCC present as solitary, pale, yellowish or skin colored, firm, ill-defined, flat or slightly depressed waxy or scar like lesion resembling many other benign lesions like Desmoplastic trichoepithelioma. mBCC is most frequently seen on head and neck areas, especially on the face [1,2,3] and less frequently in the trunk and limbs.

Treatment of Morpheaform Basal Cell Carcinoma

Several treatment modalities are being tried including imiquimod 5% cream, photodynamic therapy, Cryosurgery, Radiation Therapy, Curettage and Desiccation and local surgical excision. Although local surgical excision or other alternatives may be sufficient for most of the BCC or mBCC, recurrent rates may be high. For this reason Mohs micrographic surgery is suggested to avoid recurrence and for the high-risk and disfiguring anatomical sites like face where tissue conservation is very important [4].

References:

1. Burdon-Jones D, Thomas PW. One-fifth of basal cell carcinomas have a morphoeic or partly morphoeic histology: implications for treatment. Aust J Dermatol 2006; 47: 102–105.
2. Scrivener Y, Grosshands E, Cribier B. Variations of basal cell carcinomas according to gender, age, location and histopathological subtype. Br J Dermatol 2002; 147: 41–47
3. Erba P, Farhadi J, Wettstein R, Arnold A, Harr T, Pierer G. Morphoeic basal cell carcinoma of the face. Scand J Plast Reconstr Surg Hand Surg. 2007;41(4):184-8.
4. Rowe DE, Carroll RJ, Day CL Jr: Mohs surgery is the treatment of choice for recurrent (previously treated) basal cell carcinoma. J Dermatol Surg Oncol 15:424, 1989