Necrotic Chest Wall Mass: Atypical Presentation of Giant Basal Cell Carcinoma

Axial flap for giant basal cell carcinoma of the anterior chest wall: Case report

Introduction and importance

Anterior chest wall Giant Basal Cell Carcinoma (GBCC) is rare amongst GBCC cases and results in a large defect that is challenging to resect and reconstruct. It requires multidisciplinary approach to prevent recurrence.

Case presentation

A 72-year-old man with giant basal cell carcinoma at the anterior chest wall measuring 10 × 6 cm. Wide resection of 1 cm margin with axial flap was performed to close the defect. The follow-up report stated that the patient was satisfied with the result and there was no recurrence observed.

Clinical discussion

Review of literatures concludes that GBCC is excised with a minimum of 4-6 mm margin outside the tumor area. The axial IMAP flap is ideal to close the upper chest wall defect because of the better aesthetic outcome compared to other conventional flaps, especially in stable elderly male, patients with noninfected wound. Increased skin laxity and more relaxed skin tension associated with aging allows easier tissue mobilization and transfer to close the defect.

Conclusion

Axial flap for GBCC in anterior chest wall is ideal, safe, and has the advantage of aesthetic reasons of suitable skin tone, particularly for stable elderly male patients.

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A 72-year-old man presented with a seven-year history of ulcerating mass on his anterior chest wall.

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Histopathologic examination confirmed the diagnosis of giant basal cell carcinoma (GBCC).

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We performed wide resection with 1 cm margin and reconstruct the defect with axial flap.

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No evidence of recurrence observed after 1 year of resection.