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The primary mode of spread of basal cell carcinoma is by direct extension. From 1894 to June 1977, 119 cases of metastatic basal cell carcinoma were reported in the world literature. We wish to report five additional cases. It is our feeling that the spread of these tumors is by the interstitial route. It is standard teaching that the interstitial embolic spread of cancer does not occur, but these five cases give strong supporting evidence to the previously reported suggestion that this route of spread may be common. The concept has considerable implications regarding treatment of most cancers.
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Scanlon et al. (1980) studied this question.
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