Management and Repair of a Large Basal Cell Carcinoma With Associated Varicosities Draining Into the Right Internal Jugular Vein.

Basal cell carcinoma (BCC) is the most prevalent skin cancer and carries a favorable prognosis when treated early. Mohs micrographic surgery (MMS) is the standard of care for large BCCs greater than 2 cm on the trunk or extremities, given its ability to achieve a high cure rate while maximizing preservation of healthy tissue. While arborizing telangiectasias are a hallmark feature, locally advanced tumors may demonstrate more obvious varicosities that warrant more rigorous preoperative planning. Herein, we present a case of a large BCC on the upper back with pronounced varicosities draining into the right internal jugular vein treated with MMS. Preoperative imaging and clinical evaluation were important for ensuring treatment success in this locally advanced BCC. The tumor cleared in one stage, and a 14-month follow-up revealed no tumor recurrence and regression of the aberrant vascularization.