Basal cell carcinoma of the conchal bowl: interdisciplinary approach to treatment

The auricle is the site of only 6% of cutaneous neoplasms, but represents an area of high risk for recurrence. The purpose of this work is to present a series of patients with basal cell carcinoma (BCC) of the conchal bowl, and a review of the literature concerning the management of such patients, and to propose an algorithm for use in the treatment of such cases.

Nine patients with BCC of the conchal bowl were treated using an interdisciplinary approach. Each patient was assessed by both otolaryngology and dermatology.

None of the patients was found to have clinical evidence of significant spread into the external auditory canal (EAC). All were treated with Mohs' micrographic surgery (MMS). In each case, otolaryngology was available to perform en bloc resection of the temporal bone, should the tumour be found to extend significantly into the EAC such that it could no longer be accessed by MMS. None of the patients were found to have such extension. All cases were reconstructed using full-thickness skin grafts. All patients remain free of recurrence at an average follow-up of 12.2 months.

Based on our experience and a review of the literature, we propose an algorithm for use in the management of BCCs of the conchal bowl. We suggest that an interdisciplinary approach that combines the efforts of otolaryngology and dermatology can provide optimal care by saving patients needless procedures and loss of cosmetically important tissue.