Giant Basal Cell Carcinoma: A 12-Year Follow-up Case Report

GIANT NODULAR BASAL CELL SKIN CANCER

Clinical observations of primary giant nodular basal cell skin cancer in two patients with a gender ratio of 1:1 at the age of 64 and 68 years and disease duration of 20 and 15 years, respectively, are presented. The reasons for the late appeal of patients for medical help are established - psychological states of fear and anxiety. The clinical picture of the presented observations was characterized by a slow long-term asymptomatic growth of solitary tumor-like nodes of a mushroom-shaped form of stagnant pink color with a bumpy surface, densely elastic consistency, soldered to the underlying soft tissues, sizes 9.5x7.0 cm and 5.0x9.0 cm, respectively. Giant basaliomas were localized on the scalp in a woman and on the skin of the trunk in a man. The clinical features of the tumors corresponded to those of a large conglomerated basal cell skin cancer. A description of the clinical and dermatoscopic picture of giant nodular basaliomas is presented. The patients underwent radical surgical excision of tumors with pathomorphological examination of the postoperative material. The histological picture of giant basal cell carcinoma in both cases is represented by tumors of a complex structure - a solid adenoid type with invasion into the reticular dermis and subcutaneous fat. The low biological potential of giant nodular basaliomas has been established.

Giant basal cell carcinoma associated with vitiligo

We report a woman with two giant Basal cell carcinomas (BCCs) on the back, the largest with 12 cm in diameter, inside a vitiligo plaque. They were metatypical subtype BCC associated with a nodular subtype area. Thinking of BCC in vitiligo lesion is extremely important. Giant BCC and vitiligo are rare association.

Giant morphea-form basal cell carcinoma of the umbilicus: Successful debulking with vismodegib

Basal cell carcinoma of the umbilicus is very rare. The nodular subtype is the main representative. Giant basal cell carcinomas represent around 1% of all basal cell carcinomas. The hedgehog pathway inhibitor vismodegib is indicated for advanced basal cell carcinoma and CD56-negative immunostaining seems indicative for successful treatment. A 54-year-old man presented a 10 cm × 14 cm large and 4.5 cm deep morphea-form basal cell carcinoma with faint immunohistochemical CD56 expression arising from the umbilicus. A sequential treatment was initiated with debulking using vismodegib 150 mg per day for 4 months, followed by reconstructive surgery. To the best of our knowledge, this is the first report of a giant basal cell carcinoma of the morphea-form type of the umbilicus. The sequential treatment plan reduces the duration of vismodegib inherent adverse effects and significantly reduces the tumor mass prior to surgery. Besides increasing adherence to vismodegib treatment, this approach facilitates the surgical technique and improves cosmetic outcome.