Basal cell carcinoma arising in the Large hemangioma simplex on the face

A hemangioma simplex (HS) or a port-wine stain has a tendency to darken in color and to become thickened gradually in its natural history. But it is uncommon for a skin cancer to develop inside an HS.We report a case of a 64-year-old female, who had a large HS on her face from birth, in which a basal cell carcinoma (BCC) developed. At first an excisional biopsy was done to define the histological diagnosis of the nodule which developed on her lower lip, and the diagnosis was BCC. Then a wide local excision of the nodule with 5mm surgical margin and plasty of the enlarged lip and tongue were performed under general anesthesia. At 11 months after the final operation, no sign of loco-regional recurrence was observed.There have been reported 19 cases of BCC developing inside HS in the literature. Eleven of these cases had some previous treatments for HS, such as thorium-X irradiation or cryotherapy. The etiological significance of the therapy is still unknown but is discussed in this article. [Skin Cancer (Japan) 2004; 19: 198-202]