Giant basal cell carcinoma of the scalp in an elderly adults. Case Report.

Abstract

Objective: To describe the clinical characteristics of a pigmented basal cell carcinoma in a geriatric patient, which is considered an atypical presentation in the scalp.
Clinical case: 83-year-old patient attends to consultation due to the presence of two neoformations in the scalp wich presented an increase in their extension in the past two years, accompanied by hair loss and itching. As a diagnostic and therapeutic protocol, a comprehensive clinical assessment is initially carried out supervised by physical examination directed with polarized cross-light dermatoscopy of both lesions, which in the dermatological analysis meet the criteria of malignancy and high suspicion of basal cell carcinoma, which is why it was decided to perform an incisional biopsy on both of the neoformations. The start of non-surgical therapy is proposed based on monthly cryotherapy sessions and outpatient local chemotherapy. Upon interpretation of the histopathological report of both biopsies, the diagnosis is confirmed and the lineage of the skin neoplasia is defined with the subclassification of pigmented basal cell carcinoma correlating with the diagnostic impression previously described. Currently the patient is in her second cycle of cryotherapy, with an adequate response to the treatment.
Conclusion: The giant basal cell carcinoma is considered a less frequent variation on skin neoplasms, becoming a challenge for therapeutics due to its characteristics and dimensions. Currently, multiple pharmacological therapies, cryotherapy, dermabrasions and specialized surgeries are used in its treatment, with the aim of giving the patient a wide variety and therapeutic options depending on the particular case.