Management of patients with giant basal cell carcinoma during SARS COV2 outbreak in Italy

Abstract

Basal cell carcinoma (BCC) is the most frequently occurring type of all cancers, and represents 80% of all skin cancer. The estimated lifetime risk for BCC in the white population is between 33% and 39% for men and 23% and 28% for women. Its incidence doubles every 25 years and is increasing in the young population. Death is uncommon and seems to decrease in the last years, probably due to early and better diagnosis. BCC arises from abnormal and uncontrolled growth of basal cells. It is a slow‐growing tumor, therefore usually curable at an early stage with surgery or alternative treatment, such as cryotherapy, laser, photodynamic therapy, retinoids and topical agent like 5‐Fluorouracil cream, imiquimod cream, and so forth. Topical treatment of superficial basocellular carcinoma is a viable option, when surgery is not an advisable treatment, especially in the case of giant basocellular carcinoma. In this subtype, imiquimod 5% cream can be a safe and effective treatment, but there are few reports in available literature. We present our case series of eight patients with superficial giant basocellular carcinoma successfully treated with imiquimod 5% cream, which showed clinical improvement after 8 weeks of treatment.

Case report: Sequential treatment strategy for advanced basal cell carcinoma in Gorlin-Goltz syndrome: integration of vismodegib, radiotherapy, surgery, and high-intensity focused ultrasound

“…In the case presented, a multimodal treatment approach integrating radiotherapy, Vismodegib, and High-Intensity Focused Ultrasound (HIFU) was employed, reflecting a tailored strategy aimed at addressing the complexities associated with advanced BCC. This approach is supported by the examination of various case reports highlighting the necessity for innovative and individualized treatment modalities in managing giant BCC ( 23 – 27 ).…”

Topical and Intralesional Immunotherapy for the Management of Basal Cell Carcinoma

“…However, in the subgroup of patients with low-risk recurrence or medical contraindications for surgery, new non-surgical treatment alternatives can provide an excellent oncological and cosmetic outcome [ 3 ]. An evident and justified instance of these local therapies occurred during the COVID-19 pandemic, a period when surgical interventions carried out in hospital settings were not a viable option [ 5 ].…”

Basal Cell Carcinoma Perineural Invasion and Suggestive Signs of Perineural Invasion—Findings and Perspectives

“…Basal cell carcinoma (BCC), a malignant tumor with a keratinocyte origin, is a non-melanoma skin cancer (NMSC) with increasing incidence worldwide and has the capacity to develop from a benign lesion (verruca vulgaris) or an inflammatory dermatopathology (such as systemic sclerosis) by develops from the basal cells of the hair follicle or from those found at the level of the inter-follicular epidermis [ 1 , 2 , 3 , 4 ]. In the United States of America (USA), BCC has reached top incidences (an increasing trend paralleling that of skin infections) of as high as 50% of all types of cancers, but with low mortality and high morbidity rates (if it is left untreated for a long period of time) [ 5 , 6 ]; it is one of the most frequent malignant tumors found among the white population [ 7 ], with a lifetime risk of developing such a tumor of approximately 28% for women and as high as 39% for men [ 8 ].…”

“…This being said, treatment is patient-oriented and established according to the individual’s characteristics (general health condition, location of tumor, recurrence risk) [ 13 ]. Tumors that are diagnosed at an early stage or superficial basal cell carcinomas may benefit from local treatments such as laser, cryotherapy, photodynamic therapy, retinoids or topical agents (5-Fluorouracil or imiquimod cream) [ 8 ]; cases of superficial BCCs (a low-risk tumor) include the single BCC subtype approved for treatment with 5-fluorouracil, imiquimod and ingenol mebutate [ 14 , 15 , 16 , 17 ]. There are some general indications regarding BCC topical treatment, being indicated for superficial tumors, small and/or multiple lesions, the elderly, immune suppressed patients, those with surgery phobia and those with cosmetic sequelae [ 17 ].…”