Giant basal cell carcinomas: a result of neglect?

Although the occurrence of giant basal cell carcinoma in clinical practice is quite rare, there are some references to these malignancies in the literature. Our study includes 12 patients without previous treatment who had giant basal cell carcinoma with no evidence of metastatic dissemination. Depending on the anatomic region, we used a primary suture, local flap and split-thickness skin grafts for the reconstruction of the defect after the wide excision of the carcinoma. All patients have been followed up and no recurrence has been detected to date. Nine lesions diagnosed on the face (69%) were obvious, and therefore they should have been diagnosed at their early stage. In our series most of the patients had had tumors for more than 3 years (except 2 cases) with no history of radiation exposure or recurrence after previous treatment. Therefore our findings suggest to us that the primary reason for a tumor to achieve this giant size was neglect.