title: Use of a perimeter technique with Mohs micrographic surgery in the resection of a giant basal cell carcinoma.
abstract: BACKGROUND
  Giant basal cell carcinomas (GBCC) can demonstrate very malignant behavior and pose a surgical challenge.
  
  
  OBJECTIVE
  To present a surgical technique utilizing Mohs and the resection of narrow bands of tissue to excise a GBCC that created a large facial defect of 5 cm × 2 cm.
  
  
  METHODS
  A unique combination of Mohs micrographic surgery and the recently described perimeter techniques used for lentigo maligna were used to resect the tumor.
  
  
  RESULTS
  This hybrid technique was tissue sparing and therefore helped prevent the complications associated with a larger resection and allowed for an easier reconstruction. At 2 months post resection the patient had no known metastasis or tumor recurrence.
  
  
  CONCLUSIONS
  This case highlights the importance of early recognition of basal cell carcinoma and the complications that can arise when lesions are left untreated for a long duration. Also, we describe a surgical technique that could help reduce the complications associated with these large tumors.
authors.affiliation: Department of Dermatology, Mount Sinai School of Medicine, New York, NY, USA.
authors.forename: Katherine
authors.initials: K
authors.lastname: Nolan
authors.forename: Michelle
authors.initials: M
authors.lastname: Henry
authors.forename: Michael
authors.initials: M
authors.lastname: Shohet
authors.forename: Ebrahim
authors.initials: E
authors.lastname: Elahi
authors.forename: Ellen
authors.initials: E
authors.lastname: Marmur
mesh_terms: D002280:Basal Cell Carcinoma / Q000473:pathology / Q000601:surgery*; D005153:Facial Neoplasms / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015580:Mohs Surgery; D019651:Plastic Surgery Procedures; D012878:Skin Neoplasms / Q000473:pathology / Q000601:surgery*