Invasive giant basal cell carcinoma of the head: case report, reconstruction choice and literature review

AbstractIt is unusual to find a giant invasive basal cell carcinoma in the occipital region of the head. We are presenting a case of basal cell carcinoma invading and eroding occipital bone, managed with an unusual scalp reconstruction method. A 69-year-old female presented with a 16x19 cm diameter tumour in the occipital region. Preoperative biopsy revealed a basal cell carcinoma. A complete surgical excision of the tumour was performed in one-step surgery and tissue defect was reconstructed by a pedicle latissimus dorsi musculocutaneous flap. Our case shows that this distant pedicle flap is safe and reliable, and should be revised as the option for the occipital region reconstruction.

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Standard surgical excision and reconstruction of giant basal cell carcinoma of the face: may be an alternative to the Mohs micrographic surgery

Journal of the European Academy of Dermatology and Venereology ◽

10.1111/jdv.12360 ◽

2014 ◽

Vol 28 (11) ◽

pp. 1572-1573 ◽

Cited By ~ 1

Author(s):

M. Tuerdi ◽

A. Yarbag ◽

A. Maimaiti ◽

A. Mijiti ◽

A. Moming

Keyword(s):

Basal Cell Carcinoma ◽

Cell Carcinoma ◽

Basal Cell ◽

Surgical Excision ◽

Mohs Micrographic Surgery ◽

Micrographic Surgery ◽

The Face ◽

Giant Basal Cell Carcinoma

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Basal Cell Carcinoma Surgery: Simple Undermining Approach in Two Patients with Different Tumour Locations

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2017.143 ◽

2017 ◽

Vol 5 (4) ◽

pp. 506-510

Author(s):

Georgi Tchernev ◽

Cristiana Voicu ◽

Mara Mihai ◽

Tiberiu Tebeica ◽

Nely Koleva ◽

...

Keyword(s):

Basal Cell Carcinoma ◽

Cell Carcinoma ◽

Basal Cell ◽

Surgical Excision ◽

Good Prognosis ◽

Complete Surgical Excision ◽

Skin Cancers ◽

Human Malignancy ◽

Hedgehog Signalling Pathway ◽

Cure Rates

Basal cell carcinoma (BCC) is the most common human malignancy, accounting for the majority of all non-melanoma skin cancers (NMSC). In the past several decades the worldwide incidence of BCC has constantly been increasing. Even though it is a slow growing tumour that, left untreated, rarely metastasizes, it has a distinctive invasive growth pattern, posing a considerable risk for local invasion and destruction of underlying tissues, such as muscle, cartilage, bone or vital structures. Advanced BCCs include such locally invasive or metastatic tumours. Complete surgical excision is the standard therapy for most uncomplicated BCC cases with good prognosis and cure rates. Treatment of advanced forms of BCCs poses significant therapeutic challenges, most often requiring complicated surgery, radiotherapy, and/or targeted therapies directed towards the sonic hedgehog signalling pathway (SHH). We present two cases of large BCCs located on the scalp and posterior thorax, which underwent surgical excision with clear margins, followed by reconstruction of the defect after extensive undermining of the skin.

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Pigmented Paraaxillary Located "Complex" Basal Cell Carcinoma Imitating clinically irritated Melanocytic Lesion - Succesfull Surgical Approach in Bulgarian Patient

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2017.141 ◽

2017 ◽

Vol 5 (4) ◽

pp. 497-500

Author(s):

Cristiana Voicu ◽

Mara Mihai ◽

Mihai Lupu ◽

James W. Patterson ◽

Nely Koleva ◽

...

Keyword(s):

Basal Cell Carcinoma ◽

Cell Carcinoma ◽

Basal Cell ◽

Histopathological Examination ◽

Surgical Excision ◽

Melanocytic Lesion ◽

Complete Surgical Excision ◽

Axillary Region ◽

The Right ◽

Clinical Subtype

BACKGROUND: Basal cell carcinoma (BCC) is the most frequently encountered neoplasm worldwide. While nodular BCC is the most frequent clinical subtype, other forms of BCC, such as superficial, cystic, morpheiform, infiltrative, and pigmented may also be encountered.CASE PRESENTATION: We present the case of a 67-year-old male with a relatively well-defined infiltrative, pigmented plaque with multiple colours and peripheral growth situated in the right axillary region. The histopathologic examination performed after complete surgical excision of the tumour revealed a complex pigmented BCC with macronodular, fibroepithelioma-like, cystic, focally infiltrative and basosquamous features.CONCLUSION: Uncommon locations of BCCs in sun-protected areas such as the axillary region require a higher degree of suspicion for diagnosis. The complex histology of the presented case, including subtypes with differing biologic attributes, emphasises the importance of histopathological examination in the diagnosis and therapeutic management of BCC.

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Giant basal cell carcinoma of the face: surgical management and challenges for reconstruction

The Journal of Laryngology & Otology ◽

10.1017/s0022215115003333 ◽

2015 ◽

Vol 130 (2) ◽

pp. 176-182 ◽

Cited By ~ 3

Author(s):

A Maimaiti ◽

A Mijiti ◽

A Yarbag ◽

A Moming

Keyword(s):

Basal Cell Carcinoma ◽

Cell Carcinoma ◽

Head And Neck ◽

Basal Cell ◽

Neck Region ◽

Surgical Excision ◽

Advancement Flap ◽

Single Stage ◽

Skin Malignancy ◽

Giant Basal Cell Carcinoma

AbstractBackground:Giant basal cell carcinoma, in which the tumour measures 5 cm or greater in diameter, is a very rare skin malignancy that accounts for less than 1 per cent of all basal cell tumours. Very few studies have reported on the incidence, resection and reconstruction of this lesion worldwide.Methods:In total, 17 patients with giant basal cell carcinoma of the head and neck region underwent surgical excision and reconstruction at our hospital. Medical charts were retrospectively reviewed and analysed.Results:The lesion was usually in the forehead, eyelid, lips or nasal-cheek region. The greatest diameter ranged from 5 to 11 cm, with 5–6 cm being the most common size at the time of presentation. All patients had their tumour resected and reconstructed in a single-stage procedure, mostly with a local advancement flap, and with no post-operative flap failure.Conclusion:Giant basal cell carcinoma of the head and neck can be successfully treated with a local flap in a single-stage approach.

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Comparative Analysis of the Applicability of Island Flap in Primary and Recurrent Basal Cell Carcinomas of Similar Localization

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2018.189 ◽

2018 ◽

Vol 6 (6) ◽

pp. 1077-1080

Author(s):

Georgi Tchernev ◽

Ivanka Temelkova ◽

Hristo Mangarov ◽

Konstantin Stavrov

Keyword(s):

Basal Cell Carcinoma ◽

Cell Carcinoma ◽

Basal Cell ◽

Surgical Excision ◽

Good Prognosis ◽

Individual Risk ◽

Complete Surgical Excision ◽

Basal Cell Carcinomas ◽

The Individual ◽

The Right

BACKGROUND: Basal cell carcinoma belongs to non-melanoma skin cancers and is the most prevalent neoplasia that shows a tendency to increase over the last few decades. It occurs most often in skin areas exposed to sunlight. It is characterised by slow progression, low tendency to metastasising and good prognosis when the right choice of treatment has been made. The difficulty in the treatment of basal cell carcinomas is determined by their localisation and puts to the test the aesthetic potential of dermatosurgeons. Complete surgical excision is the standard approach in most uncomplicated cases. In relapsing basal cell carcinoma or carcinoma with aggressive or unfavourable histopathological characteristics, the clinician faces the dilemma of identifying the most appropriate method of treatment. To find the decision, help comes from the individualisation of each case and the related risk factors.CASE REPORT: Two cases of basal cell carcinoma of similar localisation are presented, where the carcinomas are removed using island flaps. In spite of the desire to observe the recommended field of surgical security (by the desire for the ultimate esthetic effect for the patient), one of the tumours was not completely removed, and as an alternative, reoperation was proposed using Mohs micrographic surgery (MMS).CONCLUSION: The choice of a surgical technique, which would guarantee a better outcome and could be applied depending on the individual risk factor in each patient, is discussed.

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