Beyond the skin - metastatic basal cell carcinoma in the stomach: A case report
Bibliographic record
Abstract
BACKGROUND: Basal cell carcinoma (BCC) is the most prevalent skin cancer, characterized by indolent growth and low metastatic rates. When metastatic BCC (mBCC) does occur, it most commonly involves lymph nodes, lungs, and bones, with metastases to other sites being exceptionally rare. This case reports the first documented instance of mBCC to the stomach, highlighting the importance of considering atypical metastatic sites, and the challenges associated with diagnosis and management. CASE SUMMARY: A 52-year-old male with recurrent BCC and known mBCC to the bone presented with progressive dysphagia, cranial neuropathies and generalized weakness. He had been treated with immune checkpoint inhibitors, with intermittent therapy modifications due to treatment related toxicities. His past history was notable for malignant perineural invasion, radiotherapy for osseous metastases, immune checkpoint inhibitor-induced enteritis, and osteonecrosis of the jaw. Gastroscopy revealed subepithelial gastric lesions, and biopsies confirmed mBCC - a previously unreported site of disease dissemination. A multidisciplinary team involving gastroenterology, oncology, neurology, and palliative care guided his management. Given his declining functional status and poor prognosis, he was ultimately transitioned to hospice care. CONCLUSION: Clinicians should consider atypical metastatic sites in advanced BCC. A multidisciplinary approach remains essential for timely diagnosis and coordinated management.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.003 | 0.002 |
| Science and technology studies | 0.004 | 0.002 |
| Scholarly communication | 0.003 | 0.003 |
| Open science | 0.001 | 0.003 |
| Research integrity | 0.007 | 0.004 |
| Insufficient payload (model declined to judge) | 0.003 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".