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

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.

  • Skin cancer
  • Plastic and reconstructive surgery
  • Surgical oncology
  • Surgery
  • Gastrointestinal surgery

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