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

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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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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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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Emerging concepts and recent advances in basal cell carcinoma

F1000Research ◽

10.12688/f1000research.11314.1 ◽

2017 ◽

Vol 6 ◽

pp. 2085 ◽

Cited By ~ 7

Author(s):

Mariam Totonchy ◽

David Leffell

Keyword(s):

Basal Cell Carcinoma ◽

Cell Carcinoma ◽

Basal Cell ◽

Locally Advanced ◽

Basal Layer ◽

Standard Of Care ◽

Surgical Excision ◽

Surgical Approaches ◽

Surgical Interventions ◽

Cure Rates

Basal cell carcinoma (BCC) is the most common malignancy worldwide, arising from non-keratinizing cells within the basal layer of the epidermis. The incidence of BCC continues to rise annually, increasing the burden of management of these carcinomas and the morbidity associated with their treatment. While surgical interventions such as Mohs micrographic surgery and surgical excision are the standard of care and yield the highest cure rates, the number of non-surgical interventions approved for the treatment of BCC continues to expand. We review various surgical and non-surgical approaches to the treatment of BCC, focusing on targeted molecular therapies that are approved for locally advanced or recurrent disease.

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

Open Medicine ◽

10.2478/s11536-009-0069-7 ◽

2009 ◽

Vol 4 (4) ◽

pp. 519-526 ◽

Cited By ~ 1

Author(s):

M. Sakalauskaite ◽

K. Vitkus ◽

D. Balciunas ◽

S. Sirsinaitis ◽

S. Rocka

Keyword(s):

Basal Cell Carcinoma ◽

Cell Carcinoma ◽

Basal Cell ◽

Surgical Excision ◽

Reconstruction Method ◽

Occipital Region ◽

Pedicle Flap ◽

Complete Surgical Excision ◽

One Step ◽

Giant Basal Cell Carcinoma

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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Invasive basal cell carcinoma: A case report

ARCHIVES OF HEALTH INVESTIGATION ◽

10.21270/archi.v7i3.2809 ◽

2018 ◽

Vol 7 (3) ◽

Author(s):

Ernani Canuto Figueirêdo Júnior ◽

Maria do Socorro Vieira Pereira ◽

Henrique Cezar Coutinho Barsi Filho ◽

Jadeilson de Moura Ferreira ◽

Myllena Alves Xavier ◽

...

Keyword(s):

Basal Cell Carcinoma ◽

Cell Carcinoma ◽

Basal Cell ◽

Surgical Excision ◽

Good Prognosis ◽

Low Grade ◽

Epithelial Tumor ◽

Maxillofacial Abnormalities ◽

Grade Malignancy ◽

Nodular Sclerosing

Basal cell carcinoma (BCC) is an epithelial tumor of low-grade malignancy, recurrent, with capacity for local invasion and destruction of adjacent bone or cartilage, yet rare metastasis. It presents as superficial, fibro-epithelial, nodular, sclerosing or pigmented. The best treatment is surgical excision; and frequently the cancer has a good prognosis. The purpose of this article is to study and discuss the clinical, histopathological and treatment of BCC.Descriptors: Maxillofacial Abnormalities; Neoplasms; Carcinoma, Basal Cell; Diagnosis; Therapeutics.

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Cryosurgery + 5% 5-Fluorouracil for Treatment of Superficial Basal Cell Carcinoma and Bowen’s Disease

Journal of Cutaneous Medicine and Surgery ◽

10.1177/1203475418758973 ◽

2018 ◽

Vol 22 (4) ◽

pp. 400-404

Author(s):

Laura C. Soong ◽

Christopher P. Keeling

Keyword(s):

Basal Cell Carcinoma ◽

Cell Carcinoma ◽

Basal Cell ◽

Clinical Cure ◽

Retrospective Chart Review ◽

Skin Cancers ◽

Superficial Basal Cell Carcinoma ◽

Cure Rates ◽

Lost To Follow Up

Background: Superficial basal cell carcinoma (sBCC) and squamous cell carcinoma in situ (SCCis) are 2 types of nonmelanoma skin cancers (NMSCs) that are amenable to treatment with topical 5-fluorouracil, cryosurgery, or topical imiquimod, among other destructive and surgical modalities. There are few studies examining the effectiveness of combination therapy with 5% 5-fluorouracil and cryosurgery for the treatment of sBCC and SCCis. Objectives: Our objective was to study the clinical cure rate achieved with the regimen of cryosurgery and a 3-week course of 5% 5-fluorouracil in the treatment of biopsy-proven sBCC and SCCis. Methods: A retrospective chart review of patients treated with cryosurgery and a 3-week course of 5% 5-fluorouracil was performed. Immunocompetent patients with biopsy-proven sBCC or SCCis who completed the treatment and attended a follow-up appointment at 6 months were included in the study. Results: On clinical examination, 30 sBCC lesions of the 34 that were assessed and 31 SCCis lesions of the 33 that were assessed demonstrated no evidence of recurrence. The clinical cure rates were found to be 73% (sBCC) and 82% (SCCis), with the inclusion of patients that were lost to follow-up. Conclusions: This approach may represent a suitable option for select patients for the treatment of SCCis. Further studies with a longer follow-up duration, documentation of histologic cure, and tolerability of this regimen for SCCis are needed. The effectiveness of cryosurgery and 5-fluorouracil for sBCC requires further study.

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