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

Abstract

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.

Nevus Blue as a Sporadic Finding in a Patient with a Blue Toe?

“…Any case of increasing and extending blue nevus boundaries is a major indication of their surgical removal [ 7 ] [ 11 ]. The excision should be through a technique leading to complete elimination of the lesion and should ensure compliance with the boundaries of surgical security [ 22 ]. This is easily and quickly accomplished by radical excision and closing the defect using a tissue advancement flap [ 20 ].…”

Nonsurgical treatment options for basal cell carcinoma

“…Fibroepithelioma of Pinkus refers to BCCs that resemble skin tags. They generally appear as raised pink nodules, exhibiting characteristics of both BCC and trichoepithelioma 13. These lesions tend to occur on the back and more often in women than men 4…”

Symptom management and palliative care in advanced basal cell carcinoma

“…Being locally malignant over a long period of time, BCC can lead to infiltration and damage of adjacent bone, cartilage, vascular or neural structures. This can result in occurrence of ulcerations, severe bleeding and significant anatomical deformations that are particularly unpleasant for patients, as they usually concern the face and neck area of the skin [4,5]. This could lead to social stigmatization, loneliness and mental suffering of the patients, as well as numerous somatic complications.…”