Neglected cutaneous skin malignancy: A patient with concurrent giant basal cell carcinoma and melanoma

Abstract Background Giant basal cell carcinomas (BCCs) are a rare subtype of BCC that grow to be greater than 5 cm in diameter. With the increase in size, there is a corresponding increase in metastatic rate and state of local invasion, with a clinical morphology that can be hard to differentiate fr...

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Main Authors: L. Sun, E. Tan
Format: Article
Language:English
Published: Wiley 2021-12-01
Series:Skin Health and Disease
Online Access:https://doi.org/10.1002/ski2.68
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author L. Sun
E. Tan
author_facet L. Sun
E. Tan
author_sort L. Sun
collection DOAJ
description Abstract Background Giant basal cell carcinomas (BCCs) are a rare subtype of BCC that grow to be greater than 5 cm in diameter. With the increase in size, there is a corresponding increase in metastatic rate and state of local invasion, with a clinical morphology that can be hard to differentiate from other subtypes of cutaneous malignancy. Although histologically equivalent to their common sub‐centimetre counterparts, giant BCCs can precipitate significant systematic medical morbidity as well as psychological trauma, and can be a real surgical reconstructive challenge to clinicians. Aims To add breadth to the existing cases in the literature, as well as a fresh patient perspective on the psychological challenges in a patient with Giant BCC. Materials & Methods A case from the Waikato Hospital, New Zealand referred to the Plastic and Reconstructive Department is carefully photographed, ordered, and presented. Results We present a case of a 15 cm giant BCC of the back existing alongside a neglected thick exophytic melanoma of the elbow in a patient who had been too embarrassed to approach healthcare professionals. These skin lesions were an incidental discovery by the general practitioner after the patient presented with symptoms of shortness of breath. Discussion Neglected skin cancers can fungate and be clinically morphologically confusing. Photographs of examples of these tumours can hone clinician awareness of the existance of Giant BCCs. Conclusion Giant BCCs are an entity yet to receive standardized treatment stratification. Prompt diagnosis and staging scans mean an expedited path to wide local excision and reconstruction, resulting in timely resolution of patients' immediate morbidity from their oncological disease burden.
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spelling doaj.art-f0091bab62e5475bbd70175f5e7fada72022-12-22T02:48:06ZengWileySkin Health and Disease2690-442X2021-12-0114n/an/a10.1002/ski2.68Neglected cutaneous skin malignancy: A patient with concurrent giant basal cell carcinoma and melanomaL. Sun0E. Tan1Department of Plastic Surgery Waikato Hospital Hamilton New ZealandDepartment of Plastic Surgery Waikato Hospital Hamilton New ZealandAbstract Background Giant basal cell carcinomas (BCCs) are a rare subtype of BCC that grow to be greater than 5 cm in diameter. With the increase in size, there is a corresponding increase in metastatic rate and state of local invasion, with a clinical morphology that can be hard to differentiate from other subtypes of cutaneous malignancy. Although histologically equivalent to their common sub‐centimetre counterparts, giant BCCs can precipitate significant systematic medical morbidity as well as psychological trauma, and can be a real surgical reconstructive challenge to clinicians. Aims To add breadth to the existing cases in the literature, as well as a fresh patient perspective on the psychological challenges in a patient with Giant BCC. Materials & Methods A case from the Waikato Hospital, New Zealand referred to the Plastic and Reconstructive Department is carefully photographed, ordered, and presented. Results We present a case of a 15 cm giant BCC of the back existing alongside a neglected thick exophytic melanoma of the elbow in a patient who had been too embarrassed to approach healthcare professionals. These skin lesions were an incidental discovery by the general practitioner after the patient presented with symptoms of shortness of breath. Discussion Neglected skin cancers can fungate and be clinically morphologically confusing. Photographs of examples of these tumours can hone clinician awareness of the existance of Giant BCCs. Conclusion Giant BCCs are an entity yet to receive standardized treatment stratification. Prompt diagnosis and staging scans mean an expedited path to wide local excision and reconstruction, resulting in timely resolution of patients' immediate morbidity from their oncological disease burden.https://doi.org/10.1002/ski2.68
spellingShingle L. Sun
E. Tan
Neglected cutaneous skin malignancy: A patient with concurrent giant basal cell carcinoma and melanoma
Skin Health and Disease
title Neglected cutaneous skin malignancy: A patient with concurrent giant basal cell carcinoma and melanoma
title_full Neglected cutaneous skin malignancy: A patient with concurrent giant basal cell carcinoma and melanoma
title_fullStr Neglected cutaneous skin malignancy: A patient with concurrent giant basal cell carcinoma and melanoma
title_full_unstemmed Neglected cutaneous skin malignancy: A patient with concurrent giant basal cell carcinoma and melanoma
title_short Neglected cutaneous skin malignancy: A patient with concurrent giant basal cell carcinoma and melanoma
title_sort neglected cutaneous skin malignancy a patient with concurrent giant basal cell carcinoma and melanoma
url https://doi.org/10.1002/ski2.68
work_keys_str_mv AT lsun neglectedcutaneousskinmalignancyapatientwithconcurrentgiantbasalcellcarcinomaandmelanoma
AT etan neglectedcutaneousskinmalignancyapatientwithconcurrentgiantbasalcellcarcinomaandmelanoma