A 67-year-old business executive and tennis player has a basal cell carcinoma removed from the right cheek. What is TRUE of basal cell carcinoma?Basal cell carcinoma with rolled, pearly borders
**Core Concept**
Basal cell carcinoma (BCC) is a type of skin cancer that arises from the basal cell layer of the epidermis, characterized by local invasiveness and slow growth. It is the most common form of skin cancer, often associated with sun exposure and UV radiation damage.
**Why the Correct Answer is Right**
BCC typically presents with rolled, pearly borders, giving it a characteristic appearance. This feature is due to the tumor's growth pattern, which involves the formation of a raised, translucent nodule with a rolled edge. The rolled borders of BCC are thought to result from the tumor's attempt to grow in a way that minimizes its exposure to the surrounding environment, which may help explain its slow growth rate. The rolled borders are a key clinical feature used to differentiate BCC from other types of skin lesions.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because while BCC can be pigmented, it is not a defining characteristic of the tumor. The rolled, pearly borders are a more specific and reliable feature for diagnosing BCC.
**Option B:** This option is incorrect because while BCC can be aggressive in its local invasion, it is not typically associated with metastasis. The local invasiveness of BCC is a hallmark of the tumor, but it does not usually spread to distant sites.
**Option C:** This option is incorrect because while BCC is common in sun-exposed areas, it is not typically associated with a rapid growth rate. BCC is often described as having a slow growth rate, which is one reason it is often curable with early treatment.
**Clinical Pearl / High-Yield Fact**
One important clinical correlation to remember is that BCC is more common in individuals with fair skin, light hair, and light eye color, who are more susceptible to sun damage and UV radiation-induced skin cancers. This highlights the importance of sun protection and skin cancer screening in these populations.
**Correct Answer: C.**