Clinical and pathological findings in reexcision of incompletely excised basal cell carcinomas

In common practice, patients with incompletely excised basal cell carcinoma s (BCCs) are referred to elective reexcision. In previous reports, it was o bserved that tumor cells are found in only 50% of the reexcised specimens. The authors performed a retrospective analysis of a large series of patient s to evaluate clinical and pathological findings in patients who underwent reexcision of incompletely excised BCCs. A total of 1,478 BCCs arising in 1 ,278 patients were excised by plastic surgeons in a plastic and reconstruct ive surgery department during a 4-year period. In 159 patients (10.8%), the excision was incomplete according to the pathological report. These tumors were defined as an incompletely excised BCCs. One hundred of the 159 patie nts with incompletely excised BCCs (62.9%) were reoperated. Residual tumor cells were found in 28 of 100 patients (28%) within the pathological specim en of the reexcised tissue (defined as positive reexcision, or +veRE). Ther e was no correlation between +veRE and the age or sex of the patient. Locat ion of the BCCs in the cheeks, eyelids, or ears was associated with a low p ercent of +veRE (10.0%, 13.3%, and 22.2% respectively). Pathological factor s associated with a low percent of +veRE were dermal inflammatory infiltrat e in the pathological specimen (p = 0.003) and sun damage pathological chan ges (p = 0.03), but there was no correlation with the pathological subtype distribution of the tumors. The authors conclude that lack of tumor cells a t reexcision of incompletely excised BCCs is associated with location of th e tumors in the cheeks, eyelids, and ears, and with pathological findings o f dermal inflammatory infiltrates or sun damage changes. The roles of infla mmatory and solar changes in the destruction of residual carcinoma cells sh ould be investigated further.