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Soo Park, MD
Soo Park, MD
Posted: Wednesday, February 21, 2024
A case report published in Annals of Dermatology highlighted the case of a 59-year-old female with a giant basal cell carcinoma causing axillary contracture. Abbas Albayati, MD, of Baskent University, Ankara, Turkey, and colleagues reported that the patient had no known risk factors for skin cancer, and the tumor was located in the axilla—one of the least-encountered areas of basal cell carcinoma. After surgical excision, radiotherapy, and physical therapy, the patient was followed for 3 years, and findings showed no tumor recurrence and no signs of metastasis.
“Basal cell carcinoma…is the most common type of non-melanoma skin cancer. Although [basal cell carcinoma] arises most commonly in sun-exposed areas of the body, such as the head and neck, it infrequently can be seen in sun-protected parts as well,” stated Dr. Albayati and colleagues.
This case report tracked the patient from diagnosis to 3 years after initial treatments. The patient presented with an open wound in the right axilla, which was associated with a brownish, foul-smelling discharge. An MRI of the axillary region was performed and revealed a local tumoral invasion enclosing the brachial plexus and axillary artery and vein. Once a biopsy confirmed the diagnosis of basal cell carcinoma, a wide excision and reconstruction with a latissimus dorsi musculocutaneous flap was performed. Prior to surgery, right arm abduction was limited to 50°; however, immediately after surgery, abduction of 140° was recovered.
After surgery, the patient received 15 sessions of radiotherapy, was started on 150 mg orally of the Hedgehog pathway inhibitor vismodegib, and began physiotherapy for shoulder movement recovery. At the 3-month rehabilitation mark, right shoulder abduction was reported to be 160°. Additionally, at the 3-year follow-up, there was no sign of recurrence or metastasis. Although this case is quite rare, the successful clinical outcomes reported led authors to conclude that latissimus dorsi muscle flap is an advisable option for such axillary defects.
Disclosure: The study authors reported no conflicts of interest.
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