Linear basal cell carcinoma: Report of seventeen cases and review of the presentation and treatment

BACKGROUND. Linear basal cell carcinoma was first described as a distinct c linical morphologic variant in 1985. Subsequently, twelve cases were report ed. OBJECTIVE. To review and identify cases of linear basal cell carcinoma in o ur institutions and determine optimal treatment based on review of our case s and those in the literature. METHODS. Primary basal cell carcinomas treated at the three campuses of May o Clinic and the University of Montreal were reviewed retrospectively, as w ere the twelve cases in the literature. RESULTS. Seventeen cases of linear basal cell carcinoma were identified. Th e age and sex ratios were similar to those of patients with standard basal cell carcinomas. Based on the review of the few reported cases of linear ba sal cell carcinoma (29), the percentage of aggressive histologic subtypes ( 38%) was increased compared with that in a general population. The average number of Mohs layers required for treatment was higher than that reported for standard basal cell carcinoma, an indication of increased subclinical s pread. CONCLUSION. Linear basal cell carcinoma is an uncommonly recognized morphol ogic variant. Based on the small number of cases, these tumors have more ag gressive histologic subtypes. Because of the possibility for increased subc linical spread, Mohs micrographic surgery can be considered for treatment. Further studies are needed to confirm these findings.