title: Giant basal cell carcinoma surgical management and reconstructive challenges.
abstract: Basal cell carcinoma is exceedingly common, but tumors >5 cm in size or giant basal cell carcinomas (GBCCs) are rare. We retrospectively review 10 GBCCs in 8 patients treated by aggressive surgical excision and reconstruction in a single operative procedure. With the exception of 1 chest lesion, all GBCCs involved the face or scalp. The 10 large defects were reconstructed with 5 free-tissue transfers, 2 pedicled musculocutaneous flaps, and 3 rotational skin flaps. There has been no evidence of local recurrence or metastasis in a mean follow-up of 29 months. Neglect has a well-established role in the presence of GBCCs, with undiagnosed preexisting medical problems also common. Surgical excision and reconstruction is the treatment of choice and can be readily accomplished in a single procedure with few complications, good oncologic control, and acceptable cosmetic results.
authors.affiliation: Department of Plastic Surgery, University of Tennessee College of Medicine-Chattanooga, Chattanooga, TN 37403, USA.
authors.forename: Phillip L
authors.initials: PL
authors.lastname: Lackey
authors.forename: Larry A
authors.initials: LA
authors.lastname: Sargent
authors.forename: Lesley
authors.initials: L
authors.lastname: Wong
authors.forename: Mark
authors.initials: M
authors.lastname: Brzezienski
authors.forename: J Woodfin
authors.initials: JW
authors.lastname: Kennedy
mesh_terms: D000328:Adult; D000368:Aged; D002280:Basal Cell Carcinoma / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery*; D018286:Carcinoma, Giant Cell / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies