Aggressive and Neglected Basal Cell Carcinoma

BACKGROUND: Basal cell carcinoma (BCC) is the most common cutaneous malignancy and usually has a benign coarse. Rarely, examples of aggressive and neglected types of this tumor are seen. OBJECTIVE: To present an interesting and dramatic example of how some people neglect their tumors and how devastating the sequelae can be. METHODS: We report a 58-year-old man with an extensive BCC and signs of cranial nerve involvement. RESULTS: The patient had a large, infected ulcer on his scalp. He also had skull bone destruction, osteomyelitis, mastoiditis, cranial nerve paralysis, and radiographic features of the skull base and upper cervical soft tissue involvement. Pathologic studies revealed an infiltrating form of BCC. CONCLUSIONS: If left untreated and neglected, as in this case, BCC can become inoperable and complicated.