Shangraw Sarah, Stone Rivka C, Cho-Vega Jeong Hee, Kirsner Robert S
Oregon Health and Science University School of Medicine, Portland, OR, USA.
Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA.
Case Rep Dermatol. 2016 Dec 13;8(3):363-368. doi: 10.1159/000452323. eCollection 2016 Sep-Dec.
Giant basal cell carcinomas (GBCCs) are large basal cell carcinomas (BCCs; <5 cm) with a greater propensity to invade and metastasize than standard BCCs. The presence of 2 GBCCs in a single individual is rare. We present the case of a 71-year-old Caucasian male with bilateral GBCCs on the dorsal forearms, measuring 130 cm and 24 cm, respectively, that developed over a 21-year period. Over this period, the patient treated the tumors with herbal remedies. Histologic evaluation showed a conventional nodular BCC for both tumors. Computed tomography and magnetic resonance imaging revealed a T4N0M0 stage for the larger lesion. Surgical excision and grafting and reconstruction were offered, but he declined. This case highlights a shared belief in holistic treatments and rejection of Western medical interventions that are common among many patients with GBCC. Studies reporting nonsurgical treatments for GBCCs, including radiotherapy, vismodegib, topical imiquimod, and acitretin are reviewed.
巨大基底细胞癌（GBCCs）是一种大型基底细胞癌（BCCs；直径<5 cm），与标准BCCs相比，其侵袭和转移倾向更大。单个个体出现2例GBCCs的情况较为罕见。我们报告了1例71岁的白种男性病例，其双侧前臂背侧患有GBCCs，大小分别为130 cm和24 cm，病程长达21年。在此期间，患者使用草药治疗肿瘤。组织学评估显示，两个肿瘤均为传统结节型BCC。计算机断层扫描和磁共振成像显示，较大的病灶为T4N0M0期。我们为患者提供了手术切除、植皮和重建治疗，但他拒绝了。该病例凸显了许多GBCC患者对整体治疗的共同信念以及对西方医学干预的排斥。本文回顾了有关GBCCs非手术治疗的研究报告，包括放射治疗、维莫德吉、外用咪喹莫特和阿维A。
