Basal cell carcinomas occur in up to 39% of Caucasian men and 28% of women. Rarely it can present a management dilemma in patients with neglected locally advanced disease of large dimension or involvement of critical structures. The Hedgehog pathway is constitutively active in almost all basal cell carcinomas and patients with Naevoid Basal Cell Carcinoma Syndrome have germline mutations in the Patched tumor suppressor gene, a Hedgehog pathway component, on chromosome 9q. This case describes an elderly patient with an untreated sporadic Basal cell carcinoma whose dimensions precluded local management approaches. The Hedgehog pathway inhibitor Vismodegib had a dramatic response allowing definitive treatment to be pursued.

基底细胞癌发生在高达 39% 的高加索男性和 28% 的女性中。对于患有被忽视的大面积局部晚期疾病或涉及关键结构的患者，它很少会出现管理困境。Hedgehog 通路在几乎所有基底细胞癌中都具有组成型活性，并且患有 Naevoid 基底细胞癌综合征的患者在染色体 9q 上的 Patched 肿瘤抑制基因（一种 Hedgehog 通路成分）中具有种系突变。该病例描述了一位患有未经治疗的散发性基底细胞癌的老年患者，其尺寸排除了局部管理方法。Hedgehog 通路抑制剂 Vismodegib 具有显着的反应，可以进行明确的治疗。