(Last Updated On: December 1, 2021)

Jianella Catrisse D. Diaz, MD, Daisy King-Ismael, MD, FPDS,
Ma. Luisa Abad-Venida, MD, FPDS, Zharlah Gulmatico-Flores, MD, FPDS

Abstract

Introduction: Basal cell carcinoma (BCC) is the most common type of malignancy worldwide. The incidence of BCC is positively
associated with increasing age; thus, centenarians, defined as those aged 100 years and above, become a vulnerable population
to developing malignancy. As a person ages, risk factors such as chronic sun exposure, ionizing radiation, and immunosuppression induce mutations that contribute to tumor formation. Impaired DNA repair capacity in response to carcinogens and immune
function dysfunction also increases BCC risk in the elderly. Currently, studies among centenarians with high-risk basal cell carcinoma treated with surgical interventions are limited.

Case Report: Presented herewith is a case of a 101-year-old female with a 15-year history of hyperpigmented, hyperkeratotic
plaque over the right malar area and a one-year history of progressive pain (PS 10/10) and enlargement of the lesion, forming an
ulcerated, hyperpigmented tumor. Laboratory workup showed normal findings. Histopathology was signed out as a pigmented
nodulocystic basal cell carcinoma. Moh’s micrographic surgery (MMS) and cheek advancement flap were performed with good
wound healing and no perioperative complications.

Conclusion:Despite the limited options of medical and physical management due to decreased life expectancy of centenarians, MMS remains the standard of therapy in high-risk BCC. MMS with reconstructive surgery is generally a safe and effective
modality with no increased risk of peri- and post-operative complications

 

Keywords: Basal cell carcinoma, centenarians, Moh’s micrographic surgery

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