engleski

Giant basal cell carcinoma treated as a venous ulcer

Introduction. Basal cell carcinoma (BCC) is the most common skin cancer in humans, typically occurring in areas of chronic sun exposure. It is usually slow growing, but if unrecognized, neglected or inadequately treated, may cause local destruction and disfigurement. Giant BCC is a rare form of BCC, defined as lesion more than 5 cm at its largest diameter. It displays a more aggressive behavior, usually resulting in local invasion, tissue destruction and metastasis. Aim. To present complexity in diagnostic approach and diagnosis of ulcers on the lower legs and the differential diagnosis. Case report. We present a case of a 58-year-old woman with a three-year history of a slow growing, nonhealing, asymptomatic ulcer on her left calf. Unrecognized as a tumor, it was treated as a venous ulcer using split skin autograft. Three skin graft attempts resulted in a graft rejection and the lesion continued to spread locally. At the time of diagnosis, the lesion measured 12, 5x10 cm, with a small areas of necrosis close to the margins. Pathohistologic examination from the ulcer border revealed an ulcerative BCC. Conclusion. Most of the times, it is possible to diagnose specific skin disease from the clinical picture alone. Some diseases can mimic others, or present with similar local findings. Pathohistologic examination is simple and effective diagnostic method, and it should be performed in all nonhealing ulcers, especially if they appear on non predilection sites for venous ulcers. Different medical specialists are directly involved in diagnosis and treatment of diseases and often come in touch with similar problems and the same patients. With respect to professional expertise, communication between specialists is essential to establishing collaborative care practices.

Giant cell carcinoma; diagnostic approach; diagnosis of ulcers on the lower legs

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