Basal Cell Carcinoma (Basalioma): Symptoms, Treatment, and Follow-Up Care for Skin Cancer

The term “basalioma” refers to a skin tumor that originates in the cells of the basal layer of the skin.

In international medical literature, the condition is also referred to as “basal cell carcinoma.” Basal cell carcinoma is classified as an epithelial skin tumor and develops in the lower layer of the epidermis, or outer layer of the skin.

Unlike malignant melanoma or squamous cell carcinoma of the skin, basal cell carcinoma usually grows slowly and rarely metastasizes to other organs. For this reason, the tumor is often classified as a semimalignant condition.

According to the Society of Epidemiological Cancer Registries in Germany, basal cell carcinoma is one of the most common forms of skin cancer. Approximately 180,000 people are diagnosed with it each year. This makes the disease a major component of the topic of skin cancer. Basal cell carcinoma also plays a significant role in the context of cancer in Germany.

The most important risk factor for the development of basal cell carcinoma is long-term exposure to UV radiation. Areas particularly affected are those exposed to the sun, also known as “sun-exposed areas.” These primarily include the face, ears, forehead, nose, neck, and hands. People with fair skin, in particular, are at an increased risk of developing basal cell carcinoma. 

A genetic predisposition can also contribute to the development of the disease. For example, hereditary skin conditions such as oculocutaneous albinism or Gorlin-Goltz syndrome are associated with an increased incidence of basal cell carcinoma. In addition, people who take medications that suppress the immune system are at higher risk.

A special case is the so-called trunk basal cell carcinoma, which occurs not on a sun-exposed area of skin but on the trunk. People with this form of basal cell carcinoma have typically been exposed to arsenic over many years. In the past, the substance was primarily used as a pesticide; today, arsenic is still produced during ore mining.

In addition, environmental factors and personal leisure activities also influence the risk of developing the disease. People who frequently expose themselves to the sun without protection or regularly use tanning beds increase their likelihood of developing basal cell carcinoma.

As part of the dermatological evaluation, other skin changes are often taken into account. These include, for example, actinic keratosis as a possible precursor to skin cancer, or squamous cell carcinoma, which is also promoted by chronic sun exposure.

The diagnosis is usually made by an experienced dermatologist. A clinical examination alone often provides important clues regarding basal cell carcinoma or other forms of skin cancer.

A dermatoscope is often used for a more detailed assessment. This examination provides a magnified view of the skin lesion and helps distinguish basal cell carcinoma from other tumors.

However, a tissue sample must be taken to definitively confirm the diagnosis. The removed tissue is then examined histologically. This allows pathologists to identify the typical structure of the tumor cells. Each individual tumor cell is assessed for its growth characteristics.

In cases of advanced disease, additional imaging techniques such as computed tomography (CT) or magnetic resonance imaging (MRI) are used to assess the extent of the spread.

The overall prognosis for basal cell carcinoma is very favorable. Unlike many other types of cancer, the tumor very rarely metastasizes. Therefore, the chances of a cure after complete removal are excellent.

However, patients may develop multiple basal cell carcinomas or additional basal cell carcinomas over the course of their lives.

For this reason, follow-up care plays an important role. Regular checkups make it possible to detect and treat skin changes at an early stage. The German Dermatological Society therefore recommends long-term dermatological care. This applies in particular to patients with multiple basal cell carcinomas or other forms of skin cancer.

The diagnosis and treatment of basal cell carcinoma are typically performed by dermatologists. Depending on the extent of the tumor, specialists in dermatological surgery, oncology, radiation therapy, or plastic surgery may also be involved.

Interdisciplinary treatment is particularly advisable for larger tumors in the head and neck region. Early referral to an experienced center improves treatment planning and contributes to an optimal treatment outcome.