**Core Concept**
Basal cell carcinoma (BCC) is a type of skin cancer that originates from the epithelial cells of the basal layer. It is known for its local destructive growth pattern, but its ability to spread through various routes is crucial in understanding its clinical behavior.

**Why the Correct Answer is Right**
BCC typically spreads through a process called perineural invasion, where the tumor cells infiltrate and destroy the surrounding nerve fibers. This route of spread is characteristic of BCC and allows it to extend locally, often with a slow and relentless progression. The perineural invasion of BCC can lead to its spread along nerve trunks, which may result in the formation of satellite lesions or nodules.

**Why Each Wrong Option is Incorrect**
* **Option A:** Distant metastasis is not a common feature of BCC, and when it does occur, it's usually to regional lymph nodes, not through a distant route.
* **Option B:** Hematogenous spread is not a typical route for BCC, as it primarily involves local invasion and perineural spread.
* **Option C:** Lymphatic spread is rare in BCC, and when it occurs, it's usually in the form of regional lymph node metastasis, not through a lymphatic route.

**Clinical Pearl / High-Yield Fact**
The "BCC" acronym can help remember the typical behavior of this skin cancer: B - Basal cell, C - Constantly growing locally, and C - Characterized by perineural invasion.

**Correct Answer: C. Perineural invasion**