Invasive, aggressive basal cell carcinoma: carcinoma basocellulare terebrans—ulcus terebrans

The clinical picture, treatment and course of invasive, aggressive basal cell terebrans carcinoma of the face, scalp and neck in eight patients is presented in detail. Based on the analysis of these patients, as well as our experience of a total of 93 patients with aggressive, invasive basal cell carcinoma, treated so far, the conclusion is reached that basal cell terebrans carcinoma develops mainly on recurrences, that is on residual tumors, after inadequate surgical and radiation therapy. It was observed that the most aggressive tumors are those, which develop in residual tumors after radiation therapy. Due to extraordinary infiltrational growth, especially into deep structures (muscles, bones, cartilages, dura, and brain), even with extensive, mutilating operations one can never be sure that the tumor is radically removed. That is why in such cases, after extensive, mutilating operations, radiation therapy is recommended, if possible.