Recurrent sclerosing Basal-cell carcinomas requiring ablative cranio facial surgery - a 3-case report

Area of Science:

• Dermatology
• Surgical Oncology
• Plastic Surgery

Background:

• Sclerosing basal cell carcinoma (sBCC) is a rare subtype of basal cell carcinoma.
• Recurrent sBCC presents significant therapeutic challenges due to its aggressive nature and potential for extensive local invasion.

Purpose of the Study:

• To highlight the aggressive behavior of recurrent facial sclerosing basal cell carcinomas.
• To emphasize the importance of early diagnosis, radical initial treatment, and lifelong follow-up for these challenging cases.

Main Methods:

• Case series reporting on three patients with facial recurrent sBCC.
• Surgical management involving extensive craniofacial resection and reconstruction with regional or free flaps.
• Histological examination for margin control.

Main Results:

• All three cases required large ablative surgeries for tumor removal.
• Reconstruction involved complex regional or free flaps.
• The aggressive nature of sBCC necessitates meticulous surgical planning and execution.

Conclusions:

• Early and aggressive management, including complete surgical excision with clear margins, is paramount for treating recurrent facial sBCC.
• Radiotherapy serves as an alternative for select cases (small lesions, non-surgical candidates).
• Close, lifelong follow-up is essential to detect and manage potential recurrences promptly, minimizing disfigurement.