Publication:

A neglected basal cell carcinoma in a young patient:successful treatment with immunocryosurgery

Patients with neglected basal cell carcinomas (BCC) still represent in many cases a therapeutic challenge. When feasible, surgery is the preferable approach; however, surgical treatment of large tumors may require extensive reconstruction, occasionally with substantial functional and aesthetic sequels. Currently, non-surgical modalities are intensively evaluated for BCC. In one of authors’ departments the combination of cryosurgery during continuous daily imiquimod (immunocryosurgery) has been established as an effective, office-compatible tissue sparing treatment for all BCC <2cm in maximal diameter, including tumor relapses, and selected cases of larger tumors. Herein we exemplary demonstrate this modality by presenting the remarkable case of a young female patient with a giant (6x5 cm) BCC at her right temporal region that was successfully treated with immunocryosurgery: Complete clearance was achieved after five treatment courses, with corresponding treatment pauses, over a period of 11 months; the tumor remains relapse-free after 24 months follow up. Socioeconomic reasons and failure to pursue adequate health-care facilities may have contributed to neglect in the present patient. In conclusion, neglected, not complicated BCC in young patients can be successfully treated with non-surgical modalities, like immunocryosurgery.