The Epidemiological and Histopathological Profiling of Basal Cell Carcinoma: Insights from a 4-Year Institutional Cohort in a Romanian Clinical County Hospital

<b>Background/Objectives</b>: Basal cell carcinoma (BCC) of the skin is a type of non-melanocytic skin cancer. The European incidence of non-melanocytic skin cancers is 14.2 per 100,000 people, with a mortality rate of 0.5, thus ranking Europe third in the world in terms of incidence and mortality rate, according to the WHO Global Cancer Observatory. The objective of this study was to highlight the histological, epidemiological, and clinicopathological aspects of BCCs diagnosed in the Clinical Pathology Department of the Mures Clinical County Hospital between January 2021 and December 2024. <b>Methods</b>: We performed a retrospective, descriptive, observational study between January 2021 and December 2024 in the Mureș Clinical County Hospital, Targu Mureș, Romania, by analysing data from histopathological reports and histological slides from patients with a positive diagnosis of BCC. The inclusion criteria for this study consisted of patients who presented a histopathological diagnosis of BCCs during the study period. Lesions were divided into two study cohorts-a general cohort and head and neck cohort. The collected data included epidemiological data, macroscopic features, and microscopical characteristics. <b>Results</b>: A total of 540 lesions were included in this study (general cohort), of which 395 were included in the head and neck cohort. This study revealed a higher incidence of BCC in 2024, affecting mostly urban patients (<i>p</i> < 0.001), with more aggressive forms (<i>p</i> < 0.001). The tumours found among males (<i>p</i> = 0.0189) and in rural patients (<i>p</i> = 0.0126) were bigger, but the tumoural volumes decreased over time (<i>p</i> < 0.001). The mixed form of BCC was associated with more aggressive histological subtypes (<i>p</i> < 0.001). <b>Conclusions</b>: BCC presents variability depending on age, gender, environment of origin, and topography, as well as histological subtype and aggressiveness, thus highlighting the need for a personalised approach in terms of diagnostics and treatment.