# Basal Cell Carcinoma in Perianal Region: A Rare Case Presentation and Review of Literatures

## TL;DR

A rare case of basal cell carcinoma in the perianal region is presented, emphasizing the importance of recognizing unusual cancer locations.

## Contribution

This case report highlights the atypical occurrence of BCC in a sun-protected, perianal area without typical risk factors.

## Key findings

- The patient had perianal BCC without UV exposure or immunosuppression.
- Surgical excision with an advancement flap preserved function and achieved clear margins.
- The patient remains recurrence-free after three months of follow-up.

## Abstract

Basal cell carcinoma (BCC) is the most common form of non-melanoma skin cancer, typically arising in areas frequently exposed to ultraviolet (UV) radiation, such as the face and neck. Occurrence in sun-protected areas is uncommon, and perianal or genital involvement is particularly rare. In this report, we present the case of a 64-year-old patient diagnosed with perianal BCC, who lacked the commonly associated risk factors like UV radiation exposure and immunosuppression. This case highlights the need for clinical awareness of atypical presentations of BCC. Patient underwent wide local excision of the lesion with clear margins. Anal sphincter was preserved without compromising the margin status. The surgical defect was reconstructed with an advancement flap. Postoperative recovery was uneventful. Histopathological examination confirmed the diagnosis of nodular BCC with the closest margin 5 mm, which was the medial margin. Immunohistochemistry was positive for Ber-EP4 and BCL2. The patient has been kept on a three-month follow-up. History and physical examinations were performed on every follow-up. Patient is recurrence-free till the last follow-up.