CASE REPORT Superficial Spreading Basal Cell Carcinoma of the Face: A Surgical Challenge

OBJECTIVE We present the case of a white man with a facial nodule suspicious for basal cell carcinoma. METHODS Biopsy revealed clusters of basaloid tumor cells with peripheral palisading, consistent with a superficial spreading variant of basal cell carcinoma. RESULTS The patient was treated with Mohs micrographic surgery, with clear margins achieved after the second stage of excision. However, since it was a superficial spreading basal cell carcinoma, this was followed by topical imiquimod treatment. CONCLUSION Topical chemotherapy with imiquimod or 5-fluorouracil may be valuable alternatives or adjuncts, given the increased likelihood of recurrence after surgical excision of superficial spreading basal cell carcinoma. Mohs surgery is of limited value in the management of superficial spreading basal cell carcinoma because it characteristically shows areas of uninvolved skin between tumor nests.