A robust man in his 90s, who was active and living independently, presented to a dermatologist’s office after a punch biopsy specimen of an asymptomatic mass he noticed on his left cheek revealed basal cell carcinoma (BCC). Examination of the mass showed a 1.5 × 2.0-cm crusted plaque on the left marionette line. Without a discussion with his physician regarding alternative treatment options, he underwent Mohs micrographic surgery 7 weeks later, which confirmed a micronodular BCC. After a 3-stage surgery, the patient was left with a 4.5 × 5.7-cm defect with resection of most of the buccinator muscle and a partial laceration of the parotid gland. After each stage, the patient was given the option to stop the procedure. Each time, he opted to continue in hopes for a cure. He was sent home with an otolaryngology follow-up. Given the large facial defect and complications from Mohs surgery, he subsequently had another operation for further removal of positive tissue margins, parotid duct laceration repair, and cervicofacial flap reconstruction.
Lunt JM, Al-Taee A, Buckhold FR. Basal Cell Carcinoma in an Elderly Man. JAMA Intern Med. 2017;177(11):1672. doi:10.1001/jamainternmed.2017.4006
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