Abstract
Anterior chest wall giant basal cell carcinoma (GBCC) is a rare skin malignancy that requires a multidisciplinary treatment approach. This case report demonstrates the challenges of anterior chest wall GBCC reconstruction for the purpose of palliative therapy in a 72-year-old female. Surgical resection of the lesion included the manubrium and upper four ribs. The defect was closed with bilateral pectoral advancement flaps, FlexHD, and pedicled VRAM. The palliative nature of this case made hybrid reconstruction more appropriate than rigid sternal reconstruction. In advanced metastatic cancers, the ultimate goals should be to avoid risk for infection and provide adequate coverage for the defect.
Highlights
Basal cell carcinoma (BCC) is the most common, yet relatively benign and slow-growing, skin malignancy
Unlike other case reports of anterior chest wall giant basal cell carcinoma (GBCC), our patient presented with a history of a burn
In a review of 51 patients with Marjolin ulcers, 43 patients presented with squamous cell carcinoma, and only one patient presented with basal cell carcinoma
Summary
Basal cell carcinoma (BCC) is the most common, yet relatively benign and slow-growing, skin malignancy. In a review of 8 cases of GBCC, all tumors were located on the face and scalp, with the exception of one located on the left anterior chest [4]. Outcomes included free soft tissue margins and relief of pain and hygiene issues associated with the wounds [4]. In another series of cases, patients with GBCC were treated with 3 cycles of metvix photodynamic therapy and a subsequent 6-week course of topical imiquimod to decrease the size of the wound prior to excision [5]. While most cases are treated with wide local excision and reconstruction with grafting or flaps, the utility of anterior chest wall reconstruction in the context of palliative goals has not been well described
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