PERIANAL BASAL CELL CARCINOMA - A RARE CLINICAL PRESENTATION

Abstract

Basal cell carcinoma (BCC) is the most
common non-melanoma skin cancer. It
has a predilection to exposed body parts
like the head and neck. Its occurrence in
the perianal region is very rare. Contrary
to earlier reports, it is no more aggressive
in this site than the usual sites of occurrence,
and thus wide local excision
provides adequate control. Herewith reporting
a rare case of BCC of the perianal
region in a 69-year old male, treated
adequately by wide local excision.
Keyword :Basal cell carcinoma, perianal,
wide local excision Introduction:
Cutaneous malignancies are the most
common cancers in humans1. Basal cell
carcinoma is the commonest nonmelanoma
skin tumor with a predilection
for occurring in the head & neck (75-
86%)1 , which is attributed to solar exposure.
Its occurrence in non-exposed areas
such as the perianal region is rare2.
Only 3 small case series of perianal BCC
have been reported in the Western literature,
and its incidence is as yet unreported
from the Indian subcontinent3.
It has also not been reported so far from
our institution. The importance of this site
lies in the fact that such tumors have a
relatively benign behavior5. Contrary to
earlier belief, a radical surgery is unnecessary
and a wide local excision can provide
adequate tumor control1. Case report: A 65
-year old male, a manual labourer by occupation,
presented with complaints of an ulcer
in the perianal region for past 2
months. The ulcer was insidious in onset
and gradually progressed to attain the present
size. There was no associated pain,
bleeding from the ulcer or any alteration in
bowel habits since the onset of the ulcer.
He is a known hypertensive on drugs.
There was nothing contributory in the family
history. There was no history of any addictions.
Examination revealed a 3X3 cm ulceroproliferative
lesion in the perianal region from
7 o’ clock to nine o’ clock position towards
the right buttock with the medial margin
situated 4cm away from the anal verge
(Figure 1).