Types Of Basal Cell Carcinoma Research Articles

Surgical Reconstruction in Malignant Eyelid Tumors.

To report the histopathological subtypes of malignant eyelid tumors treated surgically in the author's clinic and to present the author's graft and flap preferences in the reconstruction of the eyelid defect after surgical excision. This retrospective study included 33 patients who underwent malignant eyelid tumor excision, followed by eyelid reconstruction. A frozen section was performed during surgery to assess surgical margins in all patients. Demographic characteristics, histological classification, localization, and size of the tumor, postoperative defect size, follow-up period, complications, and recurrence rate were recorded. Of the patients with a mean age of 66.6 ± 15.3 (range: 23-94), 15 (45.5%) were females and 18 (54.5%) were males. The lower eyelid was the most commonly involved site in 27 (81.8%) patients. Basal cell carcinoma was the most frequently diagnosed type of malignant cancer in 81.8% (n = 27) of the cases. Among the tumor subtypes, nodular type basal cell carcinoma was the most frequently observed subtype in 10 (30.3%) patients. Wide excision with different flap and graft techniques was performed in 26 (78.8%) patients with defect sizes of 40% or larger. In the author's study, the most preferred flap technique for anterior lamella reconstruction was the Tenzel semicircular flap (30.3% n = 10). The most frequently preferred flap for posterior lamella reconstruction was the Hughes tarsoconjunctival flap (30.3% n = 10). There were no flap or graft failures in any of the author's cases. In the treatment of malignant eyelid tumors, different local flap and graft techniques selected according to the size of the defect have successful anatomical results in reconstructive surgery after frozen section controlled excision.

Clinicodemographic and Dermoscopic Features of Basal Cell Carcinoma among Filipino Patients Seen in a Tertiary Care Clinic.

Dermoscopy enhances detection of basal cell carcinoma (BCC), especially for the pigmented subtype common among Asians. However, there is limited data on dermoscopic features of BCC in Filipinos. The objective of this study is to describe the clinicopathologic profile and dermoscopic features of BCC in Filipinos seen in a tertiary care clinic. A cross-sectional study was conducted in the Philippines from November 2019 to December 2021 in a tertiary care clinic. Fifty-three (53) lesions suspicious for BCC were analyzed using dermoscopy prior to histologic confirmation. Fifty (50) biopsy-proven BCC lesions were included in the analysis. Lesions were more commonly seen in females (72.50%), and located on the head and neck (88%). The most common histopathologic subtype was nodular (74%). The most common dermoscopic features were large blue-gray ovoid nests (86%) and ulcerations (70%). The most common BCC type among the study participants was nodular, with large blue-gray ovoid nests and ulceration seen on dermoscopy.

Myiasis in Patients after Surgery, Brachytherapy, and Exenteration of the Orbit Due to Basal Cell Carcinoma.

Massive infiltration of the orbital tissues by dipterous fly larvae (ophthalmomyiasis) occurs throughout the world but is very rare in middle Europe countries. We report a patient with periocular basal cell carcinoma treated by surgical excisions, due to relapses followed by a high dose rate of HDR Ir192 brachytherapy which led to the necessity of orbital exenteration. The patient after many surgical operations and radiotherapy for recurrent periocular basal cell carcinoma through the years. Since 2021 the patient has not attended doctors during the COVID pandemic period. Due to socioeconomic problems, the patient continued in 2023 with infiltration of the orbital cavity and paranasal sinuses with myiasis. Exenteration of the orbit can be necessary after a relapsed infiltrative type of basal cell carcinoma infiltrating also periorbital cavities. Fly maggots may have had beneficial but also destructive effects on the exenterated cavity healing process.

Socioeconomic and demographic factors in multifocal superficial basal cell carcinoma: An NCDB analysis.

e21576 Background: Multifocal superficial basal cell carcinoma (SBCC) is an uncommon clinical type of basal cell carcinoma (BCC). Usually located in the papillary dermis, it is characterized by superficial basaloid cell lobules infiltrating the dermis. This carcinoma has historically been reported to have a preference for the chest and shoulders, however, this NCDB analysis shows that the cancers reported under this code (8091) primarily appear on the vulva or scrotum. Though without significant morbidity, this lesion must be correctly identified and treated either surgically or non-invasively to achieve the best outcomes. By exploring the demographic factors of SBCC on the National Cancer Database (NCDB), important insight can be gained into its epidemiology and diagnostics, and ensure more uniform reporting of this cancer. Methods: Using retrospective cohort analysis on histologically-confirmed cases of SBCC (ICD-O-3 Code 8091) in the 2004-2020 National Cancer Database (NCDB), demographic factors such as age, sex, race, Hispanic status, insurance status, facility type, and Charlson-Deyo score were descriptively analyzed. Regression analysis was used to explore diagnostic trends of multifocal SBCC. Results: A total of 51 patients were identified in the NCDB with a diagnosis of multifocal superficial basal cell carcinoma between 2004 and 2020, and the frequency of diagnosis remained relatively constant with a rate of -0.14 (R2 = 0.11). The average age of diagnosis is 73.4 years (SD = 12.1, range = 32 - 90 years). Of the 51 patients diagnosed with multifocal superficial basal cell carcinoma, the majority were female (96%) and white (94%). The primary site of the neoplasm was the vulva in 100% of females and the scrotum in 100% of males. 50 patients underwent surgical excision at the primary site of the neoplasm, with a majority (86%) having successful excision with no residual tumor. From the data collected, 100% of patients survived after 30 and 90 days of surgery. The 2, 5, and 10-year estimated survival rates were 94%, 87%, and 57% respectively. The average survival was 11.17 years (95% CI of 9.51 - 12.84). 88% of patients had a Charles-Deyo score of 0. The patient’s primary payor at diagnosis was Medicare (73%). For valid patients, the most common treatment facilities were comprehensive community cancer programs (45%). Conclusions: This NCDB analysis helps to address the knowledge gap for multifocal SBCC with information about survival and socioeconomic data that further differentiate this diagnosis from classical BCC, and previous descriptions of multifocal SBCC. Most patients diagnosed with multifocal SBCC are white females with neoplasm of the vulva, which differs from previous reporting of the chest and shoulders as the most common site of multifocal SBCC. In light of this NCDB analysis, further research is needed to help elucidate the impact of socioeconomic factors on diagnosis in this patient population.

Multiple squamous cell carcinomas of temporal bone years after radiotherapy for malignancy glottis-report of a rare case with review of literature

Larynx is unique in its anatomy. It is critical to map the lesions accurately so that the patient may benefit from the strategy most likely to preserve a functional larynx with the lowest likelihood of recurrence and the least morbidity. We describe a case of 60-year-old male with malignancy glottis diagnosed at the age of 43, treated with external beam radiotherapy, presented 15 years after with swelling in the right upper part of the face, lateral to the eye. Radiological investigations suggested neoplasm in the skin over the right zygomatic part of the temporal bone. Biopsy confirmed malignancy, basal cell carcinoma type. Wide local excision of the lesion with split skin grafting was done. After 2 years, he presented with right ear pain, discharge, and hard of hearing. Examination and radiological investigations confirmed a mass in the external auditory canal, infiltrating through the temporal bone. Biopsy revealed an acantholytic variant of squamous cell carcinoma (SCC). The patient was advised about treatment options and radiotherapy was chosen. Further, a literature search was conducted to detect similar cases. We describe the incidence and prevalence of radiation-induced temporal bone malignancy, an exceedingly rare and late complication of head and neck irradiation. Radiation induced SCCs are highly malignant secondary neoplasms in the head and neck region. It constitutes a therapeutic challenge because of its anatomy and the known side effects of radiation. Timely intervention with a multidisciplinary approach is necessary.

Cutaneous Superficial Basal Cell Carcinomais a Basal Cell Carcinoma In Situ: Electron Microscopy of a Case Series of Basal Cell Carcinomas.

Basal cell carcinoma (BCC) is the most common skin cancer. Skin cancers may present either as a non-invasive tumor or an invasive malignancy. The terminology of carcinoma in situ is used when the tumor is either just limited to epidermis or not present as single cells or nests in the dermis. However, currently the terminology superficial BCC is inappropriately used instead of BCC in situ when the skin cancer is limited to epidermis. In this study we compare the pathologic changes of superficial, nodular, and infiltrative BCCs using electron microscopy to identify the ultrastructural characteristics and validate the previously proposed terminology. Three cases of BCC (superficial BCC, nodular BCC, and infiltrative BCC) diagnosed by dermatopathologists at our institute were selected for review. Paraffin block tissues from these cases were sent for electron microscopy studies which demonstrated disruption of basal lamina in both nodular and infiltrative type of BCC, while it remains intact in BCC superficial type after extensive examination. Therefore, similar to other in situ skin cancers, there is no invasion of the neoplasm in superficial BCC into the dermis. Hence, the older term superficial BCC should be appropriately replaced with the newer terminology BCC in situ.

Basal cell carcinoma at the pinna

Basal cell carcinoma (BCC) is the most common type of non melanoma cutaneous malignancy BCC usually present on sun exposed area such as nose, mandibular, periocular region. A review of the literature revealed only a few reports of BCC on the auricle or conchal bowl. Objectives were to report a case of BCC of right pinna. A 62 year old man presented to ENT OPD with a painless blackish lesion in the right pinna appreciated since 6 months and progressively increased to the present size. On local examination of the pinna a blackish plaque with irregular margins was appreciated in the cocha, helical crus and incisura. It was soft to firm in consistency and tenderness absent. Wide excision of the lesion with healthy margin done under local anesthesia. Histopathology of excised specimen confirmed the lesion as BCC. BCC of pinna is an uncommon external ear pathology which should be kept as a differential diagnosis of lesions of the pinna by the otorhinolaryngologist.

Diagnostic Value of Dermoscopic Structures in Predicting Superficial Basal Cell Carcinoma in the Skin of Color.

Basal cell carcinoma (BCC) manifests different dermoscopic patterns in individuals with dark skin complexion compared to those with fair skin types. This study aimed to investigate the diagnostic utility of dermoscopy in discerning superficial BCC from other types of BCC, specifically in patients with dark skin complexion. This cross-sectional study focuses on patients diagnosed with BCC who were referred for skin biopsy between July 2020 and September 2022. Initially, the demographic characteristics of patients, clinical attributes of lesions, and pathological sub-types of BCC were documented. Subsequently, videodermoscopy was employed to capture comprehensive views and dermoscopic images of the lesions. Univariate logistic regression analysis was then utilized to assess the reliability of dermoscopic structures in distinguishing superficial BCC from other BCC types. Last, the study evaluated the sensitivity, specificity, positive predictive value, and negative predictive value of dermoscopy in the differentiation of superficial BCC from other BCC sub-types. The study enrolled 49 patients diagnosed with BCC, with a mean age of 66.22 ± 10.41 years. The most prevalent pathological sub-type observed was nodular (53.1%). Dermoscopy exhibited a higher specificity compared to the naked eye in the differentiation of superficial BCC from other types (55% vs. 35%, respectively). Univariate analysis revealed a significant association between spoke-wheel structures and superficial BCC (P = 0.02, odds ratio = 7.2, 95% confidence interval = 1.35-38.32). Dermoscopy exhibited superior specificity compared to the naked eye in differentiating superficial BCC from other BCC types. Notably, the spoke-wheel structure demonstrated the most robust correlation with superficial BCC.

Basal cell carcinoma - the most common form of skin cancer. Methods of treatment

Introduction: Basal cell carcinoma is the most common form of skin cancer. The lifetime risk is estimated as 33% to 39% in white men and 23% to 28% in white women. Because of that it is a very crucial disease for public health. In this article will be described main pathways of treatment which are especially recommended and are the most wide used for different types of basal cell carcinoma. Main division of interventions type used in treatment of basal cell carcinoma are surgical (physical) and non-surgical (medical). Surgical (physical) includes surgical standard excision, Mohs micrographic surgery, curettage and cautery, cryosurgery and laser therapy (ablative lasers, pulsed dye lasers). Non-surgical (medical) includes radiotherapy, topical imiquimod, topical 5- fluorouracil, photodynamic therapy, intralesional interferon. Aim of study: Literature review of the most recommended treatment of basal cell carcinoma. State of knowledge: In this publication will be desribed a current state of knowledge about basic and the most crucial basal cell carcinoma treatment. Conclusion: Because of incidence rate of basal cell carcinoma which is very high- there are many reports about treatment of this disease. Treatment of this disease, especially among low risk patients, is very effective.

Challenges in Diagnosing and Initial Treatment of Advanced Eyelid Basal Cell Carcinoma in Rural Area: A Case Report

Introduction : Basal cell carcinoma (BCC) is the most common non-melanoma eyelid cancer with a high risk of recurrence. This case report discusses the management of extensive BCC in a rural setting with limited resources.
 Case Illustration : A 62-year-old Timorese female, presented to the hospital with a mass on the left periocular region. It appeared as a mole in the lower left eyelid and extended to the surrounding tissues over nine years. As a farmer, she was frequently sun-exposed. A blackish mass was found at the left orbit, buccal, and entire nose (8 x 7.5 cm) with an ulcerated surface and attached firmly. The right eye had bedside visual acuity >6/60, with palpebral edema, free eye movement, hyperemia nasal conjunctiva, and transparent cornea. The left eye is difficult to examine. Two submandibular lymphadenopathies were palpated. A Head CT scan showed a suspected malignant soft tissue mass with irregular thickening of soft tissue with ill-defined borders. Histopathology examination revealed a nodulocystic type of basal cell carcinoma.
 Discussion : Locally advanced BCC cases need a multidisciplinary approach. In a limited resources setting, the treatment highlights are histological diagnosis, complete surgical excision, and exenteration with margin control. From a broader perspective, the role of primary health care in educating and revering for early treatment is paramount.
 Conclusion : Prevention and early treatment are the most important factors in managing locally advanced BCC.

Chinese guildeline on diagnosis and treatment of basal cell carcinoma (2023 edition)

Basal cell carcinoma (BCC) is the most common skin malignancy, with a higher prevalence in Caucasians than in East Asians. Although there is a lack of epidemiological data in China, it is generally believed that the incidence of BCC in China is increasing due to the aging population. A variety of risk factors are related to the occurrence of BCC, among which ultraviolet rays and gene mutations play a major role, especially the abnormal activation of Hedgehog (Hh) signaling pathway, which is considered to be the most important pathogenesis of BCC. The clinical manifestations of BCC are highly specific, and most experienced doctors can make a preliminary diagnosis by clinical manifestations. Dermoscopy and other imaging methods can greatly improve the accuracy of diagnosis, but there are still some atypical or rare types of BCC that need further confirmation through histopathological examination. This guideline is initiated by the National Clinical Research Center for Skin and Immune Diseases (based on Peking University First Hospital). It has invited a panel of experts consisting of 24 senior dermatologists specializing in dermatologic surgery from the Dermatologic Surgery Group of the Chinese Medical Doctor Association of Dermatology, the Dermatologic Surgery Group of the Dermatology & Venereology Committee, Chinese Association of Integration Medicine, and the Dermatologic Surgery and Cosmetic Branch of Clina Leprosy Association. In addition, experts from the Burn and Plastic Surgery (Maxillofacial), Ophthalmology, Otolaryngology, Head and Neck Surgery, Radiation Therapy, and Pathology were also invited to participate. This panel forms the "Chinese Guideline for the Diagnosis and Treatment of Basal Cell Carcinoma" expert group. Based on the latest domestic and international research findings, the guideline was developed through four rounds of discussions by the expert group and revised to provide valuable references for clinical healthcare providers in the diagnosis and treatment of BCC.

GATA3 Positively Correlates with BCL2 Expression in Indolent and Aggressive Histological Types of Cutaneous Basal Cell Carcinoma.

Some histological basal cell carcinoma (BCC) types demonstrate more aggressive behavior than others. They are known as high-risk BCC and are more challenging in therapy, contrary to indolent (low-risk) BCC types. Identifying novel protein markers to predict aggressiveness and potential therapeutic targets in challenging cases is recommended. GATA3 is a transcription factor critical for epithelial and lymphocytic differentiation. This study investigated the immunohistochemical expression of GATA3 in indolent and aggressive BCC and its association with BCL2 expression. Retrospectively collected indolent and aggressive BCC groups (24 cases each) were immunohistochemically stained with anti-GATA3 and BCL2 antibodies. The mean expression score (by area percentage) and TIL counts were determined and compared using ImageJ analysis. Stromal tumor-infiltrating lymphocytes (TIL) were counted per high-power field (HPF) on hematoxylin and eosin (H&E) staining. GATA3 and BCL2 expressions were significantly higher in the indolent group than in the aggressive group. GATA3 expression significantly correlated with BCL2 score and TIL counts. Higher GATA3 expression was significantly associated with a more indolent BCC histological type, higher BCL2 expression, and higher TIL count. GATA3 is a possible target for immunomodulation experiments to improve BCC immunotherapy outcomes.

Basal Cell Carcinoma - a Descriptive Single-institution Study

Background: Basal cell carcinoma (BCC) is the most common nonmelanoma skin cancer. Although there has been a noticeable increase in incidence over the last decades, the exact incidence is difficult to establish, because data and cancer registries are heterogeneous among countries. Objective: The study aimed to analyze the recent clinical trends of basal cell carcinoma by reviewing a six-year single institution’s experience. Methods: A total number of 582 patients with histologically diagnosed BCC were included in the study. All relevant data were collected from medical records and patients, using short questionnaire. Results: BCC was slightly more common among the male population with female to male ratio of 1:1.24. At the time of diagnosis, male patients were statistically significantly older (70.47±11.9 years) compared to female patients (67.64±12.22 years) (p=0.005). The most common types of BCC were nodular (51.64%) and superficial (25.95%), affecting most commonly the head and neck region (71.2%). Relative risk (RR) for development of BCC is 2.79 times higher in sun-exposed skin areas (p<0.001). Conclusion: Sun exposure remains one of the most important risk factors for the development of BCC, with episodes of sunburns, occupational and recreational risks noted among the majority of patients. Although non-fatal disease, due to morbidity and high frequency, prevention and early diagnosis are important to prevent further increase in the incidence of BCC among the population.

An Unusual Case of Mixed Superficial and Adenoid Basal Cell Carcinoma in a 57-year-old Filipino Female

Introduction: Basal cell carcinoma (BCC) is the most common cutaneous malignancy worldwide often occurring in sun-exposed areas. While the nodular variant accounts for the majority of cases, the adenoid type is extremely rare, comprising about 1.3% of all BCCs. Contrary to the typical presentation of BCC, adenoid BCC features a large sized lesion and a tendency to involve non-sun exposed areas such as the trunk. This case study presents a unique form of mixed superficial and adenoid BCC in a 57-year-old Filipino female. Case Report: A 57-year-old female presented with a 2-year history of a slowly enlarging bluish-black plaque with rolled borders on the left flank with noted bleeding, pain, and pruritus. Dermoscopy revealed arborizing vessels, leaf-like structures, blue gray globules, and white streaks, consistent with BCC. Histopathology showed a diagnosis of a superficial and adenoid type of BCC. Conclusion: Encounters with unusual forms of cutaneous carcinoma may arise in dermatologic practice. Dermoscopy serves as a powerful tool in identifying suspicious lesions and a pre-operative biopsy is done to correlate with the clinical diagnosis. Hence, the dermatologist will be able to decide the appropriate treatment option based on the clinical presentation and histopathologic type.

Mixed Type Basal Cell Carcinoma Treated with Excision and Defect Closure Using Advancement Flap: A Case Report

Background: Basal cell carcinoma (BCC) is a localized malignant tumor in the basal layer of the epidermis thought to be the result of prolonged sun exposure and associated with gene mutations in most cases. Although rarely metastazises, BCC can cause high levels of morbidity due to its locally destructive nature. There are several modalities for managing BCC, and the defect caused by the lesion can reconstructed by local flap.
 Case presentation: We present a 55-year-old woman with a chief complaint of a blackish lump on the left maxillary region, growing bigger, and frequent episodes of bleeding. The lesion was excised and followed by histopathological examination, which revealed mixed subtype BCC. Closure of the defect with an advancement flap was performed with favorable results.
 Conclusion: Surgical excision is the best option for managing BCC, while a skin flap is preferred to close defects for lesions on the cheek.

Хирургическое лечение базалиомы внутреннего угла глазной щели с закрытием дефекта свободным лоскутом. Клинический случай

Basal cell carcinoma is a tumor of the basal layer of the skin epithelium. It occupies an intermediate position between benign and malignant tumors. It develops from atypical basal cells of the epidermis and follicular epithelium. It does not metastasize. The occurrence on the lower eyelid is about 65 %, on the medial canthus about 15 %, on the upper eyelid about 15 % and on the lateral canthus 5 % of cases. Usually the neoplasm is painless, but more invasive basal cell carcinomas with perineural germination into the tissues of the eyelid and orbit can cause pain [1, 3]. The choice method of treatment of this disease is surgical. The operation is performed under a microscope, which allows to remove the altered tissues as much as possible and correctly match the edges of the donor material. To replace the surgical defect, a type of plastic was chosen: plastic with local tissues, free skin plastic. The skin flap was taken from the upper eyelid of the fellow eye [2]. There are several types of basal cell carcinomas: nodular, flat, and superficial. The nodular form is most common. A distinctive feature in most cases is pearl shade and waxy or translucent consistency of the tumor, more noticeable on the raised edges of the neoplasm. A characteristic and important symptom is telangiectasis marked at the edges of the neoplasm [1]. Initially, a painless nodule appears on the skin gradually, the nodule spreads over the area, accompanied by formation of ulcers, due to disturbance of blood supply and turns into ulcerative-nodular form. Ulceration can bleed. Further, basal cell carcinoma turns into a flat plaque with a peeling surface, a node protruding above the surface of the skin, or into a deep ulcer that destroys the underlying tissues. With advanced forms or inadequate treatment, the tumor can grow into the lacrimal pathways, the orbit and occasionally into the cranial cavity. The sprouting of orbital tumor causes diplopia and dislocation of the eyeball. Spontaneous regression is rare [3]. There are the following types of treatment: radiation, surgical, combined, medicinal, cryogenic, laser [4, 5]. Radiation, laser, cryogenic methods of treatment are carried out in a specialized cancer center. The surgical method is based on excision within healthy tissues with the least traumatization or destruction of surrounding tissues. Excision of a part of the eyelid weakens its horizontal tension; this circumstance requires special restorative techniques to prevent scarring. The choice method of the defect closure is the method of lateral displacement, plastic with a free flap or pedicle flap [4, 5]. Key words: basal cell carcinoma; surgery of basal cell carcinoma; plastic surgery with a free flap.

Island Pedicle Flap Pada Dinding Hidung Dengan Karsinoma Sel Basal

A flap is a tissue unit that is transferred from one area (donor site) to another area (recipient site) while still maintaining its blood circulatory system. The island pedicle flap, also known as the V-Y flap, is a modified advancement flap. This flap is a very useful reconstruction option for small to intermediate-sized defects. A 69-year-old Acehnese woman with a history of working as a farmer came with complaints of a non-painful nodule on the wall of her left nose for the last 6 months. Based on the history and physical examination, the patient was provisionally diagnosed with nodular type Basal Cell Carcinoma. An excisional surgical was performed, then a pedicle island flap was performed to close the defect. Anatomical pathology examination results concluded basal cell carcinoma. The island pedicle flap technique is one of the surgical techniques that can be an option to close tumor excision defects. This technique offers a one-stage reconstruction with excellent cosmetic results for defects in the nasal wall. The color and texture of the skin after surgery are almost perfect because the flap originates from the skin immediately adjacent to the defect.

Morphological aspects of basal cell carcinoma vascularization.

Basal cell carcinoma (BCC) is a malignant skin cancer which commonly exhibits aberrant blood flow because of angiogenesis. Its invasiveness and lack of metastatic potential may be explained by the typical pattern of vascularization seen in BCCs, where blood vessels are absent in the tumor islands and prominent in the tumor's periphery. From clinical point of view, high-frequency ultrasound (HFUS) is a useful tool for the evaluation of the lateral and depth extension of these tumors; furthermore, by employing color Doppler, important data regarding the vascularization degree of BCCs is provided. Knowingly, the sonographic vascular pattern of cutaneous tumors can aid in improving diagnosis and treatment by differentiating between benign and malignant lesions, between various types of cutaneous malignancies and also between various types of BCC (e.g., low risk versus high risk). Our aim was to perform a review integrating all currently known vascular properties of BCC as a tumor entity.

Gorlin Goltz Syndrome: A Clinical Case Report

Like most syndromic diseases, it is responsible for systemic damage. Nevertheless, the main and feared type of affection is dermatological lesions of basal cell carcinoma type. The genetic expression lies in the mutation of the PTCH gene, a tumor suppressor, located on the long arm of chromosome 9.

A Rare Case of Neglected Giant Basal Cell Carcinoma in a Nurse-Case Report and Literature Review.

Basal cell carcinoma (BCC) is the most common skin cancer in the fair-skinned adult population over 50 years of age and the incidence is rising. Generally, BCC has an indolent course, low mortality and a good prognosis due to low rates of metastasis. Giant basal cell carcinoma is a rare reported oncological entity which accounts for 0.5% to 1% of all cases of BCC and has a diameter larger than 5cm. Basosquamous carcinoma is a rare high-risk type of BCC with clinical and histopathological features of both BCC and squamous cell carcinoma. A 61-year-old female presented to our clinic for a giant bleeding tumor located under her left breast. She initially noted the tumor almost 15 years ago. Although the patient was a nurse, she was afraid to seek medical advice until an episode of significant bleeding. At presentation the tumor was a 15/7cm in size, was invading the underlying structures and had a central ulceration. The margins of the tumoral plaque had several nodules and pearly structures suggesting the possible clinical diagnosis of BCC.