# The Unexpected Guest: Basal Cell Carcinoma on a Covered Site

## TL;DR

A rare case of basal cell carcinoma appearing on a non-sun-exposed area of a 68-year-old woman's hip is reported, emphasizing the need for early diagnosis and follow-up.

## Contribution

The paper presents a rare clinical case of BCC occurring in a non-sun-exposed site, adding to the understanding of its varied presentation.

## Key findings

- BCC was diagnosed on a non-sun-exposed area of the left hip through dermoscopy and histopathology.
- Successful wide excision with clear margins was performed, and post-operative healing was satisfactory.
- The case highlights the importance of regular follow-up for patients with a history of BCC due to high recurrence risk.

## Abstract

Basal cell carcinoma (BCC) is the most prevalent form of skin cancer; it is slow-growing and locally invasive with an extremely low likelihood of metastasis. The activation of the Hedgehog (HH) signaling pathway is implicated in nearly all cases, with ultraviolet radiation being the primary risk factor. While BCC typically occurs in areas of chronic sun exposure, it can rarely develop in non-sun-exposed areas, as demonstrated by our case of a 68-year-old Indian woman presenting with a BCC lesion on her left hip. Dermoscopy revealed features suggestive of basal cell carcinoma which was subsequently confirmed as adenoid type on histopathological examination. The patient underwent a successful wide excision of the lesion with clear margins, and post-operative healing was satisfactory. This case highlights the rare occurrence of BCC in non-sun-exposed areas and underscores the importance of early diagnosis and treatment. Regular follow-up is essential, as patients with a history of BCC are at high risk for subsequent skin cancers.