Clinicopathologic Features and Outcomes of Basal Cell Carcinoma Coexisting with Other Tumors or Precancerous Lesions: A Single-Center Analysis

Abstract

Objective To characterize the clinicopathologic spectrum, treatment patterns, and outcomes of basal cell carcinoma (BCC) coexisting with other tumors or precancerous lesions. Methods We retrospectively reviewed pathologically confirmed cases diagnosed at Peking Union Medical College Hospital between 2020 and 2025. Demographic, clinical, histopathologic, treatment, and outcome data were extracted and analyzed. Results Among 860 pathologically confirmed BCC cases, 17 met the inclusion criteria. The cohort comprised 9 women (52.9%) and 8 men (47.1%), with a mean age of 56.71 ± 21.14 years. Coexisting lesions were classified as hamartoma/nevus-associated (7 cases), keratinocytic lesion-associated (5 cases), or adnexal/cyst-associated (5 cases). Nevus sebaceus was the most frequent coexisting lesion. All lesions involved the head and neck, and 16 (94.1%) showed recent enlargement or another new change on a preexisting lesion. Nodular and superficial BCC predominated. Exploratory comparison with a contemporary head and neck BCC cohort suggested that the present cohort was characterized by younger age, more frequent scalp/frontotemporal involvement, enrichment of superficial BCC, and fewer aggressive subtypes. Most patients had favorable outcomes without recurrence or metastasis observed. Conclusion BCC coexisting with other tumors or precancerous lesions has a distinct clinicopathologic profile, and often presents as recent changes in a long-standing head/neck lesion. Classification by coexisting lesion type may help integrate clinical morphology, pathology, and risk assessment.