Metastatic basal cell carcinoma originating in the supra-parotid region.

This case illustrates that massive tumor size, ulceration, or history of multiple recurrences are not absolute prerequisites for metastatic BCC. It supports the hypothesis that tumor proximity to major lymphatic systems or large-caliber blood vessels may be of significance. BCCs originating in skin overlying the parotid gland have the potential to penetrate to a rich vascular and lymphatic plexus as well as compromise the integrity of the facial nerve. Early treatment of these neoplasms utilizing accurate methods of microscopic control appears warranted to prevent the serious consequences of recurrences and deep tissue involvement.