A Large Basal Cell Carcinoma Treated With Hedgehog Inhibitor: A Case Report.

Area of Science:

• Oncology
• Dermatology
• Molecular Biology

Background:

• Basal cell carcinoma (BCC) is the most prevalent global skin cancer, with limited treatment options for advanced or unresectable cases.
• The hedgehog signaling pathway plays a crucial role in BCC pathogenesis, driven by mutations in key components like Smoothened and Patched-1.
• Hedgehog pathway inhibitors (HHIs) have emerged as a targeted therapy for advanced BCC, including agents like sonidegib and vismodegib.

Observation:

• A 61-year-old male presented with a locally advanced basal cell carcinoma of at least six years duration.
• The patient underwent treatment with a hedgehog pathway inhibitor (HHI).

Findings:

• The patient experienced significant improvement and complete regression of smaller BCC lesions after eight months of HHI therapy.
• Adverse events were mild, including hair thinning, weight loss, and accelerated nail growth.

Implications:

• This case highlights the efficacy of hedgehog pathway inhibitors in managing challenging, long-standing locally advanced basal cell carcinoma.
• Targeted therapy with HHIs demonstrates potential for substantial clinical benefit in advanced BCC, even in cases with prolonged disease duration.
• Understanding the role of hedgehog signaling provides a basis for developing novel therapeutic strategies for cutaneous malignancies.