Inoperable infiltrative basal cell carcinoma successfully treated with vismodegib

Area of Science:

• Oncology
• Dermatology
• Pharmacology

Background:

• Basal cell carcinoma (BCC) is the most common skin cancer.
• A subset of BCC cases presents with a less favorable prognosis, particularly locally advanced, recurrent, or metastatic forms.
• Surgical and radiotherapeutic options may not be suitable for all patients with advanced BCC.

Observation:

• A case of infiltrative BCC with multiple recurrences is presented.
• Initial treatment included wide excision, reconstructive surgery, and adjuvant radiotherapy.
• Subsequent recurrences were refractory to radiotherapy, topical imiquimod, and oral itraconazole.

Findings:

• Vismodegib, a small-molecule hedgehog pathway inhibitor, was administered to the patient.
• The patient achieved a complete response to vismodegib treatment.
• Symptoms associated with the locally diffused basal cell carcinoma resolved.

Implications:

• Hedgehog pathway inhibitors represent a significant therapeutic advancement for advanced BCC.
• Vismodegib provides a viable treatment option for patients with unresectable or refractory BCC.
• This case highlights the potential of targeted therapies in managing challenging skin cancer cases.