[Basal cell epithelioma with lymphogenic and hematogenic formation of metastases (a.o. into the myocardium) (author's transl)].

This report deals with a basal cell epithelioma, partially adenoid and partially morphea-like in structure, which despite intensive X-ray treatment relapsed constantly and which finally developed into an ulcus terebrans. Approximately 13 years after the primary tumor had developed (located on the left wing of the nose) both a lymphogenic and a hematogenic formation of metastases occurred with a subsequent exitus letalis 4 months later. Besides the metastases of the skin, there were multiple metastases in the lymph nodes, vertebral column, ribs, spleen, liver stomach, pleura, and peritoneum as well as in the mycardium of both ventricles and in the perimysium of the skeletal muscles. Their histological structure was similar to a partly adenoid, partly morphea-like basal cell epithelioma. The possible influence of X-ray treatment on the tumor tissue in way of benignity or malignancy is discussed in view of relevant literature of this topic. The alterations of basal cell epitheliomas into the so called transitional epitheliomas in also analyzed.