RT Journal Article SR Electronic T1 Perianal basal cell carcinoma managed with wide excision and random flap reconstruction JF BMJ Case Reports JO BMJ Case Reports FD BMJ Publishing Group Ltd SP e250493 DO 10.1136/bcr-2022-250493 VO 15 IS 6 A1 Michael Geoffrey Lee Lim A1 Marc Paul Jose Lopez A1 Jaime Antonio Ong Yu A1 Jose Paolo Pantua Albaño YR 2022 UL http://casereports.bmj.com/content/15/6/e250493.abstract AB 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.