Which cancer is more aggressive in terms of metastasis?

• A. Basal cell carcinoma
• B. Melanoma
• C. Squamous cell carcinoma
• D. Adenocarcinoma

Answer: (C)

Metastatic spread varies by tumor type, and among these common cancers, melanoma has the strongest tendency to metastasize. Basal cell carcinoma tends to grow slowly and stay localized, with metastasis being exceedingly rare. Squamous cell carcinoma can metastasize, especially from larger, poorly differentiated, or neglected lesions or in immunocompromised individuals, so it’s more aggressive than basal cell carcinoma in that respect, but overall it generally does not reach the metastatic reach of melanoma. Adenocarcinoma is a broad category with variable metastatic behavior depending on the site and subtype, but in the comparison presented, melanoma is the most likely to spread to distant sites. In ocular contexts, melanoma (such as choroidal or conjunctival melanoma) is particularly known for hematogenous spread, often to the liver.