Basal Cell Carcinoma in the Head and Neck Area: Radicalityof Tumour Removal Considering its Type

Introduction:Basal cell carcinoma is the most common skin cancer, predominantly affecting sun-exposed areas such as the head and neck.Despite its low metastatic potential, its capacity for local invasion, recurrence, and disfigurement in functionally and aesthetically critical areas requires precise surgical management.Objective: To evaluate the correlation between the histological subtype and anatomical location of basal cell carcinomas in the head and neck region with the radicality of surgical excision.Material and methods: A retrospective analysis was conducted on 300 cases of histopathologically confirmed basal cell carcinomas excised from the head and neck region in 2018-2022 at the Department of Otolaryngology and Oncological Laryngology with Clinical Department of Cranio-Maxillofacial Surgery, Military Institute of Medicine-National Research Institute, Warsaw, Poland.Tumour location, histological subtype, ulceration, presence of inflammation, elastosis, multifocality, and presence of Demodex mites were assessed in relation to surgical margin status.Results: Nodular BCC was most frequently excised with clear margins (41.2%), whereas the sclerodermiform subtype had the highest rate of incomplete excision (2.5%).Neuroinvasion was significantly more common in cases with incomplete excision (p < 0.05).No statistically significant associations were found between radicality of excision and the presence of ulceration, inflammation, Demodex mites, elastosis, multifocality, or prior surgeries.Infiltrative subtypes were associated with reduced rates of complete excision and greater surgical challenges.Conclusions: The histological subtype of BCC, particularly the presence of aggressive features such as infiltrative growth and neuroinvasion, plays a crucial role in determining the radicality of excision.In contrast, other evaluated parameters, including ulceration, elastosis, or presence of Demodex mites, did not significantly affect surgical outcomes.