Sardar Sohail Ali Khan, Muhammed Masud ul Haq.
Wide Local Excision and Split Skin Graft for Preauricular Nodular Basal Cell Carcinoma invading the Pinna.
Pak J Med Sci Jan ;18(4):319-21.

In the extirpation of basal cell caranoma there is a great risk of insufficient excision leading to recurrence and deeper invasion. This is a case report of a 72 years fair skinned lady who presented with nodular basal cell carcinoma. The lesion had started as a small painless nodule in front of the right tragus one year ago. At the time of presentation it had already invaded the right pinna. Biopsy revealed it to be the nodular variant of basal cell carcinoma. Keeping in view the histological type and patient`s wishes wide local excision of the lesion was planned and carried out. The resultant defect was covered by a split skin graft. The lesion was completely eradicated and the skin graft gave an excellent cosmetic result.

A 72 years, elderly, fair skinned lady presented with complaint of a slowly growing painless nodule that started one year ago. The nodule appeared in front of her right tragus. The nodule was followed by crops of nodules in the skin around the initial site. At the time of presentation the right pinna had been invaded and destroyed. The lobule of the right ear had virtually disappeared. However there was no pain. The patient was otherwise in good health. The biopsy of the lesion revealed nodular variant of a basal cell carcinoma. This type of BCC has the best prognosis. Keeping in view the nature of the lession, its extent and the patients wishes, wide local excision with a margin of 5 mm to 10 mm was planned and carried out. The resulting wound was covered by split skin graft harvested from the patients right thigh. The surgery produced excellent tumor eradication.

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