Case report
Basal cell carcinoma in childhood: Case report and literature review

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Childhood onset basal cell carcinoma is uncommon. In addition to occurring in children with albinism, Bazex syndrome, basal cell carcinoma nevus syndrome, nevus sebaceus, radiotherapy-treated cancers, solid organ transplants, and xeroderma pigmentosum, childhood onset basal cell carcinoma has also occurred, albeit less commonly, de novo. We describe a boy with idiopathic childhood onset basal cell carcinoma. Previously published children with de novo basal cell carcinoma were collected from computerized medical literature search (PubMed) and citations from earlier reports. To our knowledge, childhood onset idiopathic basal cell carcinoma has been observed in a total of 107 children, including our patient. Tumors were most commonly located on the head (90%). The tumors are most frequently nodular in appearance (52%) and in histology (at least 17%); however, aggressive histologic variants were observed in 20% of tumors. Basal cell carcinoma in children may be associated with prior sun exposure. The most common treatment is excision, with or without using the Mohs technique. However, 15 of 85 children, nearly 20%, developed recurrent tumors during a follow-up period ranging from 4 months to 20 years.

Section snippets

Case report

A 7-year-old boy was seen for evaluation of a violaceous 4-mm papule with a 1-mm translucent rolled border on the superior nasal bridge (Fig 1). The lesion was initially noted a year earlier when it appeared as a small “water blister.” More recently, the lesion had grown and had changed in color by becoming more violaceous. The clinical impression was either a benign adnexal tumor, a Spitz nevus, or a hemangioma.

There was no history of a precursor lesion. The child had no history of BCC nevus

Discussion

BCC is the most common form of skin cancer.54, 55, 56, 57 It typically presents in adults and has been associated with exposure to ultraviolet radiation.54, 58, 59 BCC occasionally is reported in children. In this setting, there is often an associated condition; however, de novo BCC has been observed in boys and girls 18 years of age and younger.

To our knowledge, childhood onset idiopathic BCC has been observed in a total of 107 children, including our patient (Table I).1, 2, 3, 4, 5, 6, 7, 8, 9

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    Funding sources: None.

    Conflicts of interest: None declared.

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