Perianal basal cell carcinoma managed with wide excision and random flap reconstruction

BMJ Case Rep. 2022 Jun 20;15(6):e250493. doi: 10.1136/bcr-2022-250493.

Abstract

Basal cell carcinoma (BCC) is a common skin malignancy and usually occurs in sun-exposed areas like the head and neck. Occurrence in the perianal area is rare, accounting for only 0.08% of all BCC, and 0.2% of anorectal malignancies.We present a case of a hypertensive woman in her 60s who had a 1-year history of a gradually enlarging mass on the left perianal region. Initial biopsy revealed a carcinoma with basaloid features and was confirmed on immunohistochemistry to be nodular BCC. Proctoscopy showed no intraluminal involvement. Contrast-enhanced chest and abdominal CT scans revealed no nodal or distant metastasis. MRI showed a 7.5 mm fat plane between the mass and the external sphincter muscles, projecting adequate surgical margins.A wide excision with at least 4 mm margins was performed. Reconstruction of the resulting defect was performed with a local random cutaneous flap.

Keywords: Gastrointestinal surgery; Plastic and reconstructive surgery; Skin cancer; Surgery; Surgical oncology.

Publication types

  • Case Reports

MeSH terms

  • Anus Neoplasms* / diagnostic imaging
  • Anus Neoplasms* / surgery
  • Carcinoma, Basal Cell* / diagnostic imaging
  • Carcinoma, Basal Cell* / pathology
  • Carcinoma, Basal Cell* / surgery
  • Female
  • Humans
  • Margins of Excision
  • Skin Neoplasms* / pathology
  • Skin Neoplasms* / surgery
  • Surgical Flaps