[Large multifocal basal cell carcinoma in a young man].

Area of Science:

• Dermatology
• Surgical Oncology
• Pathology

Background:

• Basal cell carcinoma (BCC) is the most common type of skin cancer, often associated with sun exposure.
• Recurrent BCC can be challenging to manage, particularly large or multifocal lesions.
• Morpheaform BCC, a subtype, can be aggressive and difficult to treat due to its infiltrative nature.

Observation:

• A 31-year-old male presented with a large (7 x 7 cm) basal cell carcinoma on the cheek and temple.
• The BCC had been present for 6 years and had been excised twice previously without success.
• Histological examination revealed a multifocal, morpheaform type BCC originating in both the epidermis and hair follicle sheath.

Findings:

• The patient underwent Mohs surgery utilizing a fresh tissue technique for complete tumor removal.
• The morpheaform basal cell carcinoma exhibited multifocal origin, presenting a complex surgical challenge.
• Following Mohs surgery, the patient experienced no recurrence of the basal cell carcinoma after one year.

Implications:

• Mohs surgery is an effective treatment for large, recurrent, and multifocal basal cell carcinomas, offering high cure rates.
• The fresh tissue technique in Mohs surgery allows for precise removal of infiltrative tumor margins, crucial for morpheaform BCC.
• Early and complete excision is vital for managing aggressive BCC subtypes to prevent local recurrence and potential disfigurement.