Orginal Publication Date
MCV/Q, Medical College of Virginia Quarterly
Skin cancer is the most frequent type of cancer, accounting for about 20% of all cancers in the State of Virginia, and the most common type of skin cancer is the basal cell carcinoma. The basal cell carcinoma is a tumor which is not considered highly malignant because, in general, it does not metastasize, although there have been a few instances in which metastases have occurred. However, such lesions may be quite destructive at times. The typical basal cell carcinoma presents as a waxy, papular or nodular lesion which has a gelatinous or somewhat translucent appearance. Coursing across the surface from the normal skin toward the center of the lesion, one will often see fine telangiectatic vessels. At times the lesions may be somewhat deceptive because of their location, and this is particularly true in the inner canthus where they may be missed until they are fairly large. Some basal cell carcinomas will remain relatively quiescent for long periods of time; others will become much more aggressive and grow rapidly. The tumor may, at times, be much like an iceberg with only the tip appearing, and this is particularly a problem with lesions on the nose. In treating a lesion in this location one has to be very cautious and be prepared to perform grafting, if this is required. It may, at times, be difficult to differentiate a basal cell carcinoma from small lesions which we call sebaceous adenomas, which occur frequently on the faces of elderly individuals. These are small waxy, creamy elevations usually on the forehead and they are the result of hyperplasia of sebaceous follicles.
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