Circumventing exenteration for giant basal cell carcinoma by neoadjuvant Sonidegib

Fig. 1: Circumventing exenteration for giant basal cell carcinoma by neoadjuvant Sonidegib. A Presentation of a 66-year-old male patient with a locally advanced tumour in the left medial canthus, anamnestic growing for approximately six years. Histopathology confirmed the diagnosis of basal cell carcinoma with a mixed nodular and infiltrative subtype. B Fifteen months later under continuous treatment with sonic hedgehog inhibitor Sonidegib (Odomzo ®) 200 mg daily and no surgical tumour resection. A substantial reduction in the tumour mass is evident clinically. C An MRI-scan at the initial presentation revealed deep orbital infiltration and long-distance contact to the nasal cavity (pointed by arrow). D An MRI-scan fifteen months later confirms a substantial reduction in the tumour mass and absence of evidence indicating orbital infiltration (pointed by arrow). In this instance, the implementation of systemic treatment has effectively circumvented the necessity for orbital exenteration or other cosmetic and functional disfiguring surgery. Full size image