Perianal basosquamous carcinoma treated with radiation therapy, a case report

Area of Science:

• Oncology
• Dermatology
• Radiation Oncology

Background:

• Perianal basal cell carcinoma (BCC) is exceptionally rare, comprising a small fraction of all BCC and anorectal neoplasms.
• Perianal lesions are more commonly squamous cell carcinoma (SCC) due to BCC's typical association with sun-exposed skin.
• Accurate diagnosis, aided by immunohistochemistry (IHC), is crucial for appropriate treatment selection.

Purpose of the Study:

• To report a rare case of perianal basal cell carcinoma (BCC).
• To illustrate the diagnostic process differentiating BCC from basaloid SCC using IHC.
• To present an alternative non-surgical treatment approach for perianal BCC in a patient with poor performance status.

Main Methods:

• A case study of an 82-year-old male with a symptomatic perianal lesion and a history of cutaneous BCC.
• Initial biopsy confirmed BCC, with IHC studies performed to distinguish it from basaloid SCC.
• Treatment involved radiation therapy (30 Gy in 5 fractions) due to patient's poor performance status, precluding wide local excision (WLE).

Main Results:

• The patient's perianal lesion was diagnosed as BCC, differentiated from SCC via IHC.
• The patient successfully tolerated radiation-only treatment.
• The non-surgical approach proved effective for this rare perianal malignancy.

Conclusions:

• Radiation therapy alone is a viable and feasible non-surgical treatment option for perianal basal cell carcinoma.
• This approach can be particularly beneficial for patients with perianal BCC who are not candidates for surgical intervention.
• Accurate diagnosis and tailored treatment are essential for managing rare perianal malignancies.