Bilateral Lymphatic Spread of Metastatic Basal Cell Carcinoma

Herein, we report a case of a patient with an abnormal skin lesion that remained unchecked by medical professionals for approximately 20 years. Upon physical examination in the emergency department for a fractured hip, an infiltrative mass was incidentally discovered. The neoplasm was noted to have progressed from an eraser-sized mass to a 3.5-cm invasive lesion. Initial surgical intervention was believed to have been successful in removal, as margins were clear with the exception of 1 indeterminate segment. However, subsequent 1-year follow-up revealed recurrence of the disease with bilateral axillary node and deep muscle involvement. This prompted a more extensive surgical approach complemented with radiation therapy. The patient had remained disease-free for a year.