Giant basal cell carcinomas, defined as lesions with a diameter reaching 5cm or more, are rare. They are usually treated by surgery, which can prove mutilating, depending on the size of basal cell carcinoma, or even impossible, depending on the patient’s age or presence of co-morbidities. Since 2003, dynamic phototherapy has become a non-invasive therapeutic alternative for basal cell carcinomas, proven effective. As early as 2010, research revealed the value of intensifying conventional phototherapy sessions with multiple methods, including fractionated CO2 laser, in order to enable trans-epidermal delivery of methyl aminolevulinate (MAL), thereby amplifying the therapeutic response.
Key Words
Giant superficial basal cell carcinoma, photodynamic therapy, fractional CO2 laser, laser assisted drug delivery
What is already known about the topic?
Giant basal cell carcinomas exhibiting diameter greater than 5cm are rare. Current therapeutic options include surgery, radiotherapy, and conventional photodynamic therapy. Treatment by photodynamic therapy can be intensified by fractional CO2 laser (assisted delivery of methyl aminolevulinate [MAL]).
What does this article bring up for us?
An alternative therapeutic modality for giant basal cell carcinoma: intensified photodynamic therapy, in this case using a fractional CO2 laser, but possibly also microdermabrasion with sandpaper, microneedling with dermarollers, or fractional radiofrequency. Intensified photodynamic therapy can reduce the number of sessions and incubation time of the photosensitizing molecule.