A super-giant basal cell carcinoma of the scalp

Abstract

Basal cell carcinoma is a malignant skin cancer, originating from basal cells. However, it is regarded more benign than other skin cancers, in the majority of the cases. If left untreated, it can lead to various complications, degradation of quality of life and even mortality to the patient. A basal cell carcinoma with one dimension more than 20 cm, is defined as super-giant. In this report, we present a case of a super-giant basal cell carcinoma occupying most of the scalp in an elderly patient, causing him severe anemia and general malaise.

Keywords: basal cell carcinoma; cancer; skin; super-giant.

Figure 1

(A and B) Macroscopic view of a super-giant basal cell carcinoma of the scalp.

Figure 2

Computed tomography findings: An enhanced heterogeneous mass extending above the scalp exerting compressive effects on the brain and concomitant diffuse bone infiltration. (A–D) Axial view; (E and F) Coronal view; (G and H) Sagittal view; (I–K) 3-D reconstruction.

Figure 3

Histopathological findings of mixed basal cell carcinoma including nodular and micronodular subtypes. (A) Two relatively circumscribed masses with epidermal attachment, consisting of large basaloid lobules with peripheral nuclear palisade. Cleft formation (or retraction artifact) between tumor lobules and stroma is also apparent (arrow). H&E ×400; (B) Small basaloid nests diffusely infiltrating the dermis with peripheral palisading less prominent than in nodular BCC. The retraction artifact is absent. There is also solar elastosis next to the lesion (arrow). H&E ×400.