RADICAL STERNO- COSTAL RESECTION OF SKIN TUMOR AND IMMEDIATE RECONSTRUCTION: A CASE REPORT

Purpose: We managed a 30 years old male Albino with Basal Cell Carcinoma of the Sternum with local deep invasion to the Pleura with the aim of offering a cure.Methodology: Information of the patient from the medical records showed a 30-year-old Albino (Fitzpatrick Skin type I) who was exposed to tropical sun rays for about three decades before presenting with 1-year history of locally advanced sternal skin basal cell carcinoma. This was resected five times in another teaching hospital, but the fungating lesion recurred locally after each attempted local wide excision.Result: He was found to have 18cm x 22cm malignant ulcer which penetrate over the manubrium and middle of the sternum. It also extended bilaterally to cover the anterior ribs and costochondral joints though his general condition was stable.Contribution to Theory, Policy and Practice: After detailed investigations and obtaining an informed consent, he had a radical en-bloc resection of the tumor: including the involved sternum and the affected anterior part of the affected pleura. Full thickness reconstruction of the anterior chest wall was done with marlex methacrylate mesh and steel wire support, obliteration of dead space, soft tissue cover with latissimus dorsi pedicle musculocutaneous flap with satisfactory outcome. The use of Stainless wires in our chest reconstruction provided a simpler and cheaper alternative to the use of advanced Tridimensional titanium printed custom made prosthesis, and less morbidity to alternative use of autologous ribs.

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Prostatic basal cell carcinoma treated by chemoradiation with weekly cisplatine: case report and literature review

African Journal of Urology ◽

10.1186/s12301-021-00178-2 ◽

2021 ◽

Vol 27 (1) ◽

Author(s):

S. Ridai ◽

C. Moustakbal ◽

A. Lachgar ◽

H. Jouhadi ◽

A. Benider ◽

...

Keyword(s):

Radiation Therapy ◽

Urinary Tract ◽

Basal Cell Carcinoma ◽

Cell Carcinoma ◽

Lower Urinary Tract Symptoms ◽

Basal Cell ◽

Lower Urinary Tract ◽

Locally Advanced ◽

Urinary Tract Symptoms ◽

Lower Urinary

Abstract Background Basal cell carcinoma of the prostate is a relatively rare entity. Their evolution is characterized by the frequency of local and/or distant relapses. Due to their rarity, the treatment is not consensual in the literature. We report here a case of Basal cell carcinoma of the prostate in a 40-year-old patient. Case presentation Our patient initially presented an obstructive lower urinary tract symptoms with a normal initial level of prostate specific antigen (PSA) test (3.5 ng/m). The transurethral resection of the prostate (TURP) was in favor of a prostatic basal cell carcinoma with its specific anatomopathological and immunohistochemical characteristics. The prostatic MRI and thoraco-abdominal CT realized after the TURP revealed a tumoral lesion of the prostatic peripheral zone with extra-capsular extension combined with right seminal vesicle invasion and a suggestion of posterior bladder wall adherence. No evidence of visceral or nodal metastases at this point. Considering the tumor being locally advanced, a concurrent chemoradiotherapy with intensity modulated technique was indicated after a multidisciplinary meeting with a 70 Gy total target dose delivered in 35 fractions and weekly Cisplatin. A year and a half after, he developed a cerebellous metastases revealed by intracranial hypertension with no other visceral lesion and complete local remission with the disappearance of the lower urinary tract symptoms and the pain and the appearance of a prostatic atrophy. The PSA level was still on the upper limit of normal. He underwent metastasectomy, and the anatomopathological study was in favor of a cerebellous metastasis of the known BCC. The patient presented postoperatively paraparesis of lower limbs with balance problems for which he was placed in palliative care with indication of postoperative radiation therapy in case of improvement of his general condition. He did not recover and deceased three months later. Conclusions The prostatic basal cell carcinoma is a rare aggressive entity often non-evoked at the clinical or radiological stages because of its unspecific appearance. The diagnostic of these tumors is based on histological examination and a large immunohistochemistry panel. Given its scarity, very few data is available for locally advanced non-metastatic stages treated by radiation therapy. We assess here a good local response with concurrent chemoradiation therapy.

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