Enmanuel Guerrero; Marx Bravo; Sebastián Orellana; Daysi Brito & Carlos Manterola

Basal cell carcinoma (BCC) is the most common non-melanoma skin cancer, predominantly affecting older adults. It originates from the basal layer of the epidermis or the hair follicle bulb and is characterized by the development of friable, non-healing, translucent, ulcerated lesions with telangiectasias, rolled margenrs, and predominantly occurs in sun-exposed areas. For recurrent, locally advanced BCC that is not amenable to surgery or radiotherapy, the use of antineoplastic agents such as Vismodegib has proven to be an alternative treatment. The aim of this report was to discuss the morphological characteristics of recurrent and locally advanced BCC and the role of Vismodegib in the treatment of these cases where surgery and radiotherapy are contraindicated. We present the case of a 77-year-old patient diagnosed with recurrent nasal BCC, treated at an oncology institute in the Andean region. Initially, she underwent wide surgical resection and grafting on two occasions (2001 & 2003). Following a third recurrence (2005), she received radiotherapy (60Gy), achieving complete remission. In 2014, she experienced a fourth locally advanced recurrence, where both surgery and radiotherapy were contraindicated. Consequently, she was treated with a selective Hedgehog pathway inhibitor (Vismodegib), achieving a complete response.

GUERRERO, E.; BRAVO, M.; ORELLANA, S.; BRITO, D. & MANTEROLA, C. Morphological aspects of recurrent, locally advanced basal cell carcinoma and the therapeutic role of Vismodegib. Int. J.Morphol., 44(2):690-697, 2026.