High-Risk BCC Of the Lower Eyelid in Patient with Presternal Located Cutaneous Melanoma and BCC Of the Shoulder: Melolabial Advancement Flap Combined with Undermining Surgical Approach As Promising Complex One Step Treatment Option!

Abstract

BACKGROUND:It is assumed that the occurrence of keratinocyte and melanocytic tumours is multifactorial driven. Certain risk factors such as solar radiation, p53 protein and Melanocortin-1 receptor (MC1R) prove to be common to their development, which at the same time shows that their simultaneous manifestation in the same patients, for example, is quite possible. Such a manifestation could be observed as collision tumours within the same solitary lesion or as a simultaneous occurrence within two completely different lesions that are clearly distinguished from one another.CASE REPORT:An 85-year-old patient is presented with three primary cutaneous tumours located in region presternal, infraorbital sinistra and scapularis extra. The lesions were removed during a single surgical session. For the high-risk basal cell carcinoma (BCC) in the lower eyelid, the so-called melolabial advancement flap was applied, and for the tumours located in the other two areas, the undermining surgical approach was applied. The subsequent histological analysis found that the case referred to two keratinocyte tumours (BCC) and one melanocyte tumour (cutaneous melanoma).CONCLUSIONS:The patient presented is interesting with regard to 1) the simultaneous presentation of three primaries with different localization (so far not described in the world literature, namely 2 basal cell carcinomas and one melanoma in the same patient concurrently), 2) one of the basal cell tumours belongs to the group of high-risk (according to the localization) and meanwhile advanced BCC (according to the infiltration degree of the underlying tissue-infiltration of the musculature) and 3) their simultaneous successful surgical treatment in a single surgical session under local anaesthesia.

Giant basal cell carcinoma of the scalp: rotation advancement flap as successful dermatosurgical approach

“…This is determined by 1) the currently available therapeutic options, 2) the patient's willingness to undergo invasive or non-invasive treatment, as well as 3) the oncology or surgical unit where the patient was admitted. While the oncology units prefer radiotherapy and targeted therapy (5), dermatosurgical/surgical units emphasize the importance of the invasive options such as complex rotational/transpositional or progressive flaps (6,7,8). For a number of patients the operability of the tumor is of great importance.…”

“…While the oncology units prefer radiotherapy and targeted therapy, 5 the dermatosurgical/surgical units emphasize the importance of invasive options such as complex rotational/transpositional or advancement flaps. 3 , 6 , 7 For a number of patients, the operability of the tumor is of great importance. It depends on the general condition of the patient and the experience of the surgical team.…”