Basal cell carcinoma of the perianal region: 20-year experience

INTRODUCTION: Although basal cell carcinoma remains the most common cutaneous malignancy, its occurrence in the perianal region is very rare. Earlier reports have suggested that basal cell carcinoma in this region may be more aggressive than basal cell carcinoma in other regions of the body. METHODS: A chart review of patients with perianal basal cell carcinoma who presented consecutively during a 20-year period (ending December 1996) was performed. Patients included were those with a histologically proven diagnosis of basal cell carcinoma in the perianal region. RESULTS: Twenty-one cases were identified (15 male) with a mean age at diagnosis of 67 (range, 43-81) years. Follow-up data were available on 19 patients with a mean follow-up time of 72 (range, 2-214) months. Seventeen patients were treated by local excision, one by electrocautery, and one by Moh's surgery. No patients developed a local recurrence. Seven patients (33 percent) had multiple basal cell carcinomas at other anatomic sites. Four patients died of other causes during the follow-up period. CONCLUSIONS: Perianal basal cell carcinoma is a rare tumor. Given the significant association with multiple lesions at other sites, a diagnosis of perianal basal cell carcinoma should prompt an examination of all cutaneous surfaces. It does not seem to be more aggressive in this region than in other areas. Local excision seems to provide adequate control.