Basal-cell Carcinoma
Authors: C. Wakeley, P. Childs
Journal: BMJ (1949)

During the last thirty-five years 237 cases of rodent ulcer have come under the care of one of us (C.W.) and 210 of these occurred on the face or scalp, while 27 were found to arise outside those confines (Figs.A andB).Summaries of the case histories of these lesions found elsewhere than on the face or scalp are now given.Umbilical Region (3 Cases) Case 1.-A man aged 58 presented himself in 1930 with a large rodent ulcer to the left side of the umbilicus.He had first noticed a small pimple in this region some 12 years pre- viously.The ulcer was irregular in outline with a heapedup and rolled-over edge (Fig. C).The ulcer measured 1{ in.(3.75 cm.) at its greatest diameter, and its base was moist and in some parts covered by small sloughs.There was no enlarge-FACE & SCALP , 210 -, FIGS.A and B.-Diagrams illustrating distribution of rodent ulcers.nt of axillary or inguinal glands.Excision of the ulcer ether with the umbilicus was undertaken through an ptical incision.Recovery was uneventful.Microscopically ulcer was a typical basal-cell carcinoma.This patient was t seen in 1939, d health and A 1 ,re was no sign ~'$" recurrence.,ase 2.-A man d 60 was first i i in October, "-7, with a small lent ulcer just ,ow the umbilimargin.it Ibeen present two years and FIG.C.-Case 1. Rodent ulcer of the s graduallY umbilical region.This lesion started as a ting bigger.pimple 12 years previously.D ulcer had an gular edge and was d in.(1.25 cm.) across at its greatest neter.Excision was undertaken through an elliptical inci- sion.Recovery was rapid and the patient was -discharged from the hospital on the fourth post- operative day.Microscopically the growth was a typical basal-cell carcifoma.The patient was well, with no sign of recurrence, two years later.Case 3.-A seaman aged 47 was seen in 1942 with a small raised growth just to the right of the umbilical margin.There was a small ulcerated area in the centre of the tumour.The patient thought he had been stung by a fish while bathing \ at?Alexandria some ten months previously.The growth was hard, with a raised edge.There were y \ no palpable glands in the axilla or the inguinal region.Excision was undertaken through an elliptical incision.Recovery was uneventful.The histological report stated that the lesion was a typical basal-cell carcinoma.This man con- tinued his war service and was discharged in 1946 quite free from any symptoms.Chest Wall and Back (3 Cases) Case 4.-A man aged 59 was seen i1930 with an irregular ulcer the size o1ia half-crown on the middle of his back on a level with the inferior 4608 13 "-- tie 3G, 1 I94! 9 ' ' ' BASAL-CiELL' CA7CINOMA.angles of the scapulae, The, patient had been conscious of a lump on the back for some five years.Excision was under- taken through an elliptical incision.Recovery was uneventful.The histology was that of a typical rodent ulcer.Case 5.-A man aged 64 was first seen In the out-patient department in November, 1945, complaining of an ulcer on the anterior chest wall about 14 in.lateral to the right sternmo- clavicular joint.Some 19 years previously it had appeared as a spot the size of a pin-head.Gradually it became enlarged, and a crust formed on it.It was never raised above the adjacent skin surface.The ulcer was treated with x rays until March, 1947, at fortnightly intervals for courses lasting two to three months each.A total dosage of 4,100 units was given.Apparent cure was obtained twice but was followed by recurrence.