Metastatic basal cell carcinoma presenting as unilateral lymphedema

BACKGROUND: Metastatic basal cell carcinoma (MBCC) is rare, occurring in only 0.0028-0.55% of all basal cell carcinomas (BCCs). Patients with MBCC may present with a variety of findings, related to the site of metastasis. OBJECTIVE: Clinical presentation of a MBCC that became symptomatic due to unilateral lymphedema and a review of the relevant literature. METHODS: Case report with literature review. RESULTS: Patients may present with lymphadenopathy, ulcerations, anemia, bone pain, or muscle weakness related to the site of metastasis. In this reported case, MBCC presented as unilateral lymphedema. Risk factors for MBCC include radiation, large and invasive tumors, and a history of recurrence. The average survival time for localized lymph node metastasis in BCC is 3.6 years. This patient is currently 2 years since MBCC presentation and is currently without evidence of recurrence. CONCLUSION: To our knowledge, we report the first case of MBCC that presented as unilateral lymphedema.