Surgical treatment of giant basal cell carcinoma of the face: our experience

Abstract

Giant basal cell carcinoma (GBCC) is a rare skin tumor with the longest diameter greater than five cm.The main factors for its occurrence are considered to be the neglect of conventional basal cell carcinoma (BCC) by patients and the biological aggressiveness of the tumor. With its slow infiltrative growth it disrupts the structural and functional integrity of the affected area. There are no guidelines for its treatment regardless of localization and it still poses a therapeutic problem.In this study, we analyzed patient and tumor characteristics and response to GBCC surgical treatment. Of the total number of patients with BCC over a period of 11 years we isolated 24 cases with GBCC. All patients were in the third age range, from 65 to 86 years old, mostly poor, prone to alcohol and depression.The size and area of the tumor in the central part of the face were slightly smaller than in the lateral part. Male gender predominated (1.4:1). All patients underwent surgical resection of the tumor with histologically confirmed free margins, as the only method of treatment. Reconstruction of the resulting defect was performed in the same procedure . During the follow-up of 36 months on average no recurrence of the disease or metastasis in any of the patients was observed. Histological processing also defined the subtype of these tumors. Most were non-aggressive, nodular form tumors. Due to the duration of the disease, an average of 5.9 years, we believe that the greatest responsibility for the development of this subtype of BCC is the indolent attitude of the patient. Facial GBCC can be successfully treated surgically in such a demanding area as the face, and regardless of the patient’s age.

Keywords

• carcinoma
• basal cell – pathology
• surgery; skin neoplasms – pathology
• surgery; facial neoplasms -– pathology