Basal cell carcinoma (BCC) is the most common type of skin cancer and primarily affects the sun-exposed areas of the body. It usually presents as visible skin lesions; cases of subcutaneous BCC without apparent skin involvement are extremely rare. Here, we present the case of an 81-year-old female who underwent hysterectomy for an ectopic pregnancy 50 years prior and presented with a subcutaneous mass in the lower abdomen that gradually increased in size over the previous 6 months. The mass only displayed a mild hypertrophic scar the color of skin at the site where a surgical drain had been inserted. Ultrasonography revealed a nonspecific soft tissue tumor, for which we recommended an ultrasound-guided biopsy. Histopathological analysis indicated the need to differentiate between BCC and trichoblastoma. Subsequent wide excision with a 5-mm margin confirmed the BCC diagnosis. This case highlights the challenges in diagnosing and managing subcutaneous BCC with unusual clinical symptoms.

Basal cell carcinoma (BCC) is the most common type of skin cancer and primarily affects the sun-exposed areas of the body. It usually presents as visible skin lesions; cases of subcutaneous BCC without apparent skin involvement are extremely rare. Here, we present the case of an 81-year-old female who underwent hysterectomy for an ectopic pregnancy 50 years prior and presented with a subcutaneous mass in the lower abdomen that gradually increased in size over the previous 6 months. The mass only displayed a mild hypertrophic scar the color of skin at the site where a surgical drain had been inserted. Ultrasonography revealed a nonspecific soft tissue tumor, for which we recommended an ultrasound-guided biopsy. Histopathological analysis indicated the need to differentiate between BCC and trichoblastoma. Subsequent wide excision with a 5-mm margin confirmed the BCC diagnosis. This case highlights the challenges in diagnosing and managing subcutaneous BCC with unusual clinical symptoms.

Basal cell carcinoma (BCC) is the most common type of skin cancer and primarily affects the sun-exposed areas of the body. It usually presents as visible skin lesions; cases of subcutaneous BCC without apparent skin involvement are extremely rare. Here, we present the case of an 81-year-old female who underwent hysterectomy for an ectopic pregnancy 50 years prior and presented with a subcutaneous mass in the lower abdomen that gradually increased in size over the previous 6 months. The mass only displayed a mild hypertrophic scar the color of skin at the site where a surgical drain had been inserted. Ultrasonography revealed a nonspecific soft tissue tumor, for which we recommended an ultrasound-guided biopsy. Histopathological analysis indicated the need to differentiate between BCC and trichoblastoma. Subsequent wide excision with a 5-mm margin confirmed the BCC diagnosis. This case highlights the challenges in diagnosing and managing subcutaneous BCC with unusual clinical symptoms.

Basal cell carcinoma (BCC) is the most common type of skin cancer and primarily affects the sun-exposed areas of the body. It usually presents as visible skin lesions; cases of subcutaneous BCC without apparent skin involvement are extremely rare. Here, we present the case of an 81-year-old female who underwent hysterectomy for an ectopic pregnancy 50 years prior and presented with a subcutaneous mass in the lower abdomen that gradually increased in size over the previous 6 months. The mass only displayed a mild hypertrophic scar the color of skin at the site where a surgical drain had been inserted. Ultrasonography revealed a nonspecific soft tissue tumor, for which we recommended an ultrasound-guided biopsy. Histopathological analysis indicated the need to differentiate between BCC and trichoblastoma. Subsequent wide excision with a 5-mm margin confirmed the BCC diagnosis. This case highlights the challenges in diagnosing and managing subcutaneous BCC with unusual clinical symptoms.

Background: Although implanting deep brain stimulation (DBS) devices carries up to a 15% risk of complications, optimal management strategies remain poorly understood. This study aimed to review the risk factors for wound complications of DBS device implantation and develop an algorithm for proper management. Methods: Patients with Parkinson disease who underwent bilateral subthalamic nucleus DBS device implantation between 2005 and 2022 were retrospectively reviewed. All DBS-related wound complications such as infection, dehiscence, erosion, and displacement were recorded, and factors associated with device explantation were also assessed. Results: A total of 398 patients underwent DBS device implantation using 796 electrodes and implantable pulse generators. During the mean follow-up of 9.8 ± 5.5 years, 28 patients (7.0%) experienced wound complications that required reoperation, including 14 infection (50.0%), 22 dehiscence (78.6%), five skin erosion (17.9%), and two device displacement (7.1%). Complications were resolved with a single reoperation in 13 patients (46.4%), while nine patients underwent 2–3 surgical procedures (32.2%), and six patients in 6–8 operations (21.4%). The device was salvaged in 16 patients (57.1%) and removed in 12 (42.9%). Infection (P = 0.010), shorter time interval from device implantation to complications (P = 0.022), higher C-reactive protein levels (P = 0.026), methicillin-resistant Staphylococcus aureus growth (P = 0.044), and history of multiple previous revisions (P < 0.001) were associated with device removal. Conclusion To maximize the therapeutic benefit of DBS and minimize the time, effort, and cost required for revision, temporary explantation in early stages followed by reimplantation of the device after the wound subsides should be considered in high-risk cases.

Background: Although implanting deep brain stimulation (DBS) devices carries up to a 15% risk of complications, optimal management strategies remain poorly understood. This study aimed to review the risk factors for wound complications of DBS device implantation and develop an algorithm for proper management. Methods: Patients with Parkinson disease who underwent bilateral subthalamic nucleus DBS device implantation between 2005 and 2022 were retrospectively reviewed. All DBS-related wound complications such as infection, dehiscence, erosion, and displacement were recorded, and factors associated with device explantation were also assessed. Results: A total of 398 patients underwent DBS device implantation using 796 electrodes and implantable pulse generators. During the mean follow-up of 9.8 ± 5.5 years, 28 patients (7.0%) experienced wound complications that required reoperation, including 14 infection (50.0%), 22 dehiscence (78.6%), five skin erosion (17.9%), and two device displacement (7.1%). Complications were resolved with a single reoperation in 13 patients (46.4%), while nine patients underwent 2–3 surgical procedures (32.2%), and six patients in 6–8 operations (21.4%). The device was salvaged in 16 patients (57.1%) and removed in 12 (42.9%). Infection (P = 0.010), shorter time interval from device implantation to complications (P = 0.022), higher C-reactive protein levels (P = 0.026), methicillin-resistant Staphylococcus aureus growth (P = 0.044), and history of multiple previous revisions (P < 0.001) were associated with device removal. Conclusion To maximize the therapeutic benefit of DBS and minimize the time, effort, and cost required for revision, temporary explantation in early stages followed by reimplantation of the device after the wound subsides should be considered in high-risk cases.

Background: Although implanting deep brain stimulation (DBS) devices carries up to a 15% risk of complications, optimal management strategies remain poorly understood. This study aimed to review the risk factors for wound complications of DBS device implantation and develop an algorithm for proper management. Methods: Patients with Parkinson disease who underwent bilateral subthalamic nucleus DBS device implantation between 2005 and 2022 were retrospectively reviewed. All DBS-related wound complications such as infection, dehiscence, erosion, and displacement were recorded, and factors associated with device explantation were also assessed. Results: A total of 398 patients underwent DBS device implantation using 796 electrodes and implantable pulse generators. During the mean follow-up of 9.8 ± 5.5 years, 28 patients (7.0%) experienced wound complications that required reoperation, including 14 infection (50.0%), 22 dehiscence (78.6%), five skin erosion (17.9%), and two device displacement (7.1%). Complications were resolved with a single reoperation in 13 patients (46.4%), while nine patients underwent 2–3 surgical procedures (32.2%), and six patients in 6–8 operations (21.4%). The device was salvaged in 16 patients (57.1%) and removed in 12 (42.9%). Infection (P = 0.010), shorter time interval from device implantation to complications (P = 0.022), higher C-reactive protein levels (P = 0.026), methicillin-resistant Staphylococcus aureus growth (P = 0.044), and history of multiple previous revisions (P < 0.001) were associated with device removal. Conclusion To maximize the therapeutic benefit of DBS and minimize the time, effort, and cost required for revision, temporary explantation in early stages followed by reimplantation of the device after the wound subsides should be considered in high-risk cases.

Background: Although implanting deep brain stimulation (DBS) devices carries up to a 15% risk of complications, optimal management strategies remain poorly understood. This study aimed to review the risk factors for wound complications of DBS device implantation and develop an algorithm for proper management. Methods: Patients with Parkinson disease who underwent bilateral subthalamic nucleus DBS device implantation between 2005 and 2022 were retrospectively reviewed. All DBS-related wound complications such as infection, dehiscence, erosion, and displacement were recorded, and factors associated with device explantation were also assessed. Results: A total of 398 patients underwent DBS device implantation using 796 electrodes and implantable pulse generators. During the mean follow-up of 9.8 ± 5.5 years, 28 patients (7.0%) experienced wound complications that required reoperation, including 14 infection (50.0%), 22 dehiscence (78.6%), five skin erosion (17.9%), and two device displacement (7.1%). Complications were resolved with a single reoperation in 13 patients (46.4%), while nine patients underwent 2–3 surgical procedures (32.2%), and six patients in 6–8 operations (21.4%). The device was salvaged in 16 patients (57.1%) and removed in 12 (42.9%). Infection (P = 0.010), shorter time interval from device implantation to complications (P = 0.022), higher C-reactive protein levels (P = 0.026), methicillin-resistant Staphylococcus aureus growth (P = 0.044), and history of multiple previous revisions (P < 0.001) were associated with device removal. Conclusion To maximize the therapeutic benefit of DBS and minimize the time, effort, and cost required for revision, temporary explantation in early stages followed by reimplantation of the device after the wound subsides should be considered in high-risk cases.

No abstract available.
Purpura