case_images: PMC11291366_01
case_images: Overview of a patient with giant BCC before treatment. (A) An 68-year-old woman presented with an enormous, fetid, abdominal wall mass. (B) Lesions of BCC on the face and neck. (C) Axial CT of the tumor, (D) Coronal CT of the tumor, (E) Sagittal CT of the tumor.
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case_images: A 68-year-old female patient of Caucasian ethnicity presented with advanced, multifocal cutaneous lesions encompassing the entire body, including facial involvement ( Figures 1A, B ). April 2022 revealed an infiltrative mass within the intra-abdominal and pelvic regions, measuring 11.4 x 3.1 x 12 cm, which infiltrates the skin and muscle layers ( Figures 1C-E ).This patient was deemed inoperable due to the extensive nature of the disease. Additionally, the patient was diagnosed with Gorlin-Goltz syndrome, a rare genetic disorder characterized by a predisposition to multiple neoplastic and non-neoplastic tumors, further complicating her clinical presentation due to the disease's multifocality and the presence of a large, partially necrotic tumor exuding a malodorous discharge.
case_images: Giant BCC during treatment. (A) Abdominal wall mass. (B) Regressive lesions on the face and neck. (C) Axial CT scan of the abdominal mass.
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case_images: Remarkably, certain flat lesions underwent near-complete resolution ( Figure 2B ). A subsequent computed tomography scan (December 19, 2023) revealed the presence of an infiltrative mass measuring 10.8x2.2x11 cm within the abdomen and pelvis ( Figure 2C ). Given the documented transient efficacy of vismodegib, typically lasting less than 12 months, and considering the patient's prolonged treatment duration exceeding one year, a multidisciplinary consultation was convened to evaluate surgical excision of the largest tumor as a potential therapeutic strategy ( Figure 2A ).
case_images: BCC during treatment (March 2024). (A) Lesion on the abdomen after skin grafting. (B) The skin of the face and neck with significant regression of most lesions.
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case_images: Dermatoscopic evaluation post-treatment revealed that lesions previously identified as basal cell carcinoma, exhibiting characteristic dermatoscopic features, had achieved complete remission and were fully cicatrized ( Figure 3B ).
case_images: BCC on the back treated with High-Intensity Focused Ultrasound (HIFU). (A) Macroscopic view before HIFU treatment.; (B) Dermoscopic view before HIFU treatment.; (C) Macroscopic view immediately after HIFU treatment.; (D) Dermoscopic view immediately after HIFU treatment.
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case_images: The patient was subsequently enrolled in a clinical trial (NCT05698706) aimed at addressing individual basal cell carcinoma (BCC) lesions located on the lower and upper back which had not regressed after prior therapy with vismodegib( Figures 4 ,  5 ).
case_images: BCC on the back treated with High-Intensity Focused Ultrasound (HIFU). (A) Macroscopic view before HIFU treatment.; (B) Dermoscopic view of the back before HIFU treatment.; (C) Macroscopic view immediately after HIFU treatment.; (D) Dermoscopic view of the back immediately after HIFU treatment.
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case_images: The patient was subsequently enrolled in a clinical trial (NCT05698706) aimed at addressing individual basal cell carcinoma (BCC) lesions located on the lower and upper back which had not regressed after prior therapy with vismodegib( Figures 4 ,  5 ).