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• W2318442038 abstract "Sir:FigureWe read with great interest the article entitled “Giant Basal Cell Carcinoma: 11-Year Follow-Up and Seven New Cases” by Manstein et al. (Plast Reconstr Surg. 2011;128:1105–1106), which is the update and integration of the case report previously published by the same authors.1 We wish to add the following comments. Our department recently reported one of the most extensive surveys in the published literature2 concerning basal cell carcinomas. A revision of our database from 1992 to 2007 shows 37 cases (18 female patients and 19 male patients) of giant basal cell carcinoma (lesions >5 cm at the greatest diameter),1 with the size of the tumors ranging from 5 to 18 cm (mean, 6.2 cm) and the site being prevalently extrafacial [21 of 37 (56.8 percent)] (Table 1).Table 1: Data for Patients with Giant Basal Cell CarcinomasIf clinical diagnosis is unclear, we prefer an incisional biopsy before final excision [17 of 37 (45.9 percent)]. For such reason, once the diagnosis of malignancy is confirmed, we will completely excise the lesion with larger margins than those (3 to 5 mm) commonly recommended.3 We agree with the authors that the use of split-thickness skin grafts is quick and practical, but we generally prefer the use of flaps [25 of 37 (67.6 percent)] over grafts [12 of 37 (32.4 percent)] because of better results with like-to-like tissue. The prevalent use of flaps does not seem to influence the extent of the excision, because we achieved complete excision margins at first surgery in 31 (83.8 percent) patients. In six patients (16.2 percent), a subsequent operation was required to achieve negative margins. As the authors write, metastatic basal cell carcinomas are extremely rare (0.003 to 0.55 percent).4 After a follow-up even longer than 15 years for some patients [seven of 37 (18.9 percent)], we have never diagnosed metastases from basal cell carcinoma, although we found a single case of perineural and another case of muscular invasion. Denis Codazzi, M.D. Stefano Bruschi, M.D. Maria Alessandra Bocchiotti, M.D. Department of Plastic Surgery, University of Turin, San Giovanni Battista Hospital, Turin, Italy Enrico Robotti, M.D. Department of Plastic Surgery, Riuniti Hospital, Bergamo, Italy DISCLOSURE The authors have no financial interest in this work." @default.
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• W2318442038 date "2012-06-01" @default.
• W2318442038 modified "2023-10-18" @default.
• W2318442038 title "Giant Basal Cell Carcinoma" @default.
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• W2318442038 doi "https://doi.org/10.1097/prs.0b013e31824efe49" @default.
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