# A Presentation of Fungating Nevoid Basal Cell Carcinoma Syndrome

## TL;DR

This paper presents a rare case of a young woman with a severe skin cancer syndrome that led to a complex treatment journey and amputation.

## Contribution

The paper highlights the impact of social determinants on managing a rare genetic skin cancer syndrome.

## Key findings

- The patient developed numerous basal cell carcinomas at a young age, consistent with Gorlin syndrome.
- A non-healing lesion on the shoulder grew into a fungating mass, necessitating amputation and leading to recurrence.
- Treatment involved a combination of electrodessication, Mohs surgery, and immunotherapy.

## Abstract

Gorlin syndrome, also known as nevoid basal cell carcinoma syndrome (NBCCS), is a rare autosomal dominant disease marked by the development of numerous basal cell carcinomas (BCC) that tend to occur at young ages. Here the authors detail a case of a young adult Caucasian female with both a complex social and medical history. These social determinants of health played a significant role during her management and treatment plan. Although the patient had many eruptions of BCC throughout her body, one chronic, non-healing BCC lesion located amidst a shoulder wound would eventually turn into an ulcerative fungating mass, resulting in amputation of the left arm with recurrence of the BCC at the site of amputation. The patient’s lesions were targeted with a combination of electrodessication and curettage (ED&C), Mohs surgery, and cemiplimab immunotherapy.