Exophytic cutaneous carcinoma of the shoulder: clinical case report and surgical management

Abstract

Background. Non-melanoma skin carcinomas, especially basal cell carcinoma (BCC), are the most common form of skin cancer. Although they rarely metastasize, they can become locally destructive, especially if not treated early. BCC does not originate from melanocytes. We present an advanced case of BCC treated surgically. Objective(s). Presentation of a clinical case of exophytic cutaneous carcinoma with slow but advanced evolution and highlighting the effectiveness of radical surgical treatment and skin reconstruction. Materials and methods. The patient underwent clinical, imaging, and paraclinical evaluation. Surgical excision of the tumor formation was performed under general anesthesia, followed by the application of an autologous full-thickness skin graft. The excised specimen was sent for histopathological analysis. The donor site was sutured and bandaged. Results. Histopathological Results. : Examination of the surgical specimen revealed: - Nodular basal cell carcinoma with solid pattern, ulcerated on the surface - Depth of invasion (DOI): 9 mm - No lymphovascular (LVi0) or perineural (Pn0) invasion - Free resection margins (R0) WHO/ICD-O code: 8097/3 The patient's late presentation allowed the evolution of a potentially treatable lesion into a bulky tumor, requiring extensive excision and skin reconstruction. Surgical treatment remains the first-line treatment for nodular basal cell carcinomas. Histopathological confirmation of complete resection is essential for a favorable prognosis. Conclusion(s). Basal cell carcinoma, while generally considered a malignancy with low metastatic potential, still requires timely and accurate diagnosis, along with proper surgical intervention, to avoid serious local complications. Skin grafting remains an effective option for reconstruction after excision.