当科における基底細胞癌の統計的観察

皮膚に発生する悪性腫瘍のうち比較的高頻度に見られる基底細胞癌(BCC)について統計的観察をおこなった.1990年1月から2001年5月までの11年5ヶ月間に川崎医科大学附属病院形成外科において治療した基底細胞癌の48患者49症例を対象として年齢・部位・臨床および組織分類・切除範囲・切除後の再建方法・再発の有無などについて若干の文献的考察をふまえて検討した.男女比は1.3 : 1,年齢は13～98歳(平均63.4歳),初診までの期間は平均3.6年であった.腫瘍の長径は4～100mm(平均15.1mm)であった.部位は顔面が最も多く眼窩部が19例(38%),鼻部が13例(26%)を占めており,いわゆる胎生期顔裂線に一致する傾向にあった.臨床分類は結節型・結節潰瘍型の2型で85%を占め,組織型ではsolid typeが75%を占めた.腫瘍辺縁からの切除距離は5mmが最多で18例(42%),次いで3mmが8例(19%)などであった.眼周囲19例に限ると切除辺縁は3～5mmが11例,3mm以下が8例であったがいずれも再発は見られなかった.再建方法は局所皮弁が最多で33例(67%)続いて単純縫縮が8例(16%),植皮が6例(12%),遊離皮弁が2例(4%)であった.再発例は頭部,顔面発症の2例であった.Basal cell carcinoma (BCC) is one of the most frequent malignant skin tumors and is often seen on the face. This study aims to analyze the tumor diameter, site, patient\u27s age, surgical treatment and so on. This study analyzed 49 cases of basal cell carcinoma (BCC) which were treated at the Department of plastic and Reconstructive Surgery at Kawasaki Medical School Hospital from January 1990 to May 2001. The patients were between (13-98) years old, average was 63.4 years. The male to female ratio was 1.3 : 1 respectively. The average duration between the onset of BCC and the patient\u27s initial visit was 3.6 years. Tumor diameter ranged from 4 mm to 100 mm (average was 15.1mm). Almost all tumors occurred on the face (especially on the so-called "facial cleft") except one case which occurred on the left knee. Eighty-five percent of clinical types of tumor were nodular and nodulo-ulcerative. Seventy-five percent of histological types were solid. Surgical excision was performed in all cases and skin defects were closed by local flaps (67%), simpleclosure (16%) and other methods. The surgical margin was less than 5 mm in 81.6% of the cases. There were 2 recurrent cases. One was a case of Xcroderma pigmentosum on the face (ulcus tereblans, solid type) and the other was case of BCC on the temporal region (nodular, keratotic type). In accordance with previous results, we suggest further detailed classification and analysis of surgical margins