Perianal Basal Cell Carcinoma: 35-Year Experience.

BACKGROUND: Basal cell carcinoma of the perianal region is a rare anorectal disease. This condition is not related to exposure to ultra-violet radiation. Due to the low prevalence and poor detection, there is a paucity of data relating to this condition in literature. Perianal basal cell carcinoma present different surgical challenges from other anatomic locations and may not share the same prevalence or natural history. Here, we describe the largest series to date on the surgical management of perianal basal cell carcinoma.

OBJECTIVE: To present our 3- year experience in managing perianal basal cell carcinoma.

DESIGN: This was a retrospective single center analysis.

SETTING: The study was conducted at a large tertiary referral academic healthcare system.

PATIENTS: All patients undergoing surgical management of pathology confirmed perianal basal cell carcinoma.

INTERVENTIONS: All patients underwent surgical management of their disease.

MAIN OUTCOME MEASURES: The primary outcomes were disease recurrence, mortality, and wound complications.

RESULTS: A total of 29 patients were identified with an average follow up of 5.5 years. 27.6% of patients had multiple basal cell carcinoma in other anatomic locations at index presentation. 93% of patients were adequately treated with local excision but 60% had wound dehiscence at time of first follow up visit. Ultimately there were no recurrences or disease related mortality during the follow-up period.

LIMITATIONS: Limitations to our study include its nonrandomized retrospective nature, single-institution experience, and small patient sample size.

CONCLUSIONS: Perianal basal cell carcinoma carries a high rate of synchronous presentation in other locations and should prompt a thorough evaluation. Perianal BCCs can and should be successfully treated with local excision despite the high rate of wound complications. See Video Abstract at https://links.lww.com/DCR/B883.