TP53 Mutated Metastatic Basal Cell Carcinoma Responsive to Sonidegib

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Brian Wanner
Austin Cusick
Jyoti Kapil
Stephen D'Addario


Basal cell carcinoma, sonidegib, nonmelanoma skin cancer, TP53


Basal cell carcinoma (BCC) is the most common nonmelanoma skin cancer (NMSC) with the potential of local invasion and distant metastasis. Our patient presented with an enlarging four-centimeter subcutaneous nodule over the right clavicle. An incisional biopsy demonstrated the unexpected findings of a nodular and infiltrative BCC. Definitive treatment was a radical neck dissection with adjuvant radiation therapy. Negative margins were confirmed on the excision and lymph node evaluation demonstrated no lymphatic spread. Surveillance chest computed tomography revealed new bilateral pulmonary nodules and a subsequent biopsy showed metastatic BCC. A genetic panel demonstrated TP53 mutations and no mutations in SMO. The patient was started on sonidegib and after ten months of therapy his disease was stabilized on repeat imaging. This case report demonstrates a rare presentation of a TP53 mutated, metastatic BCC responsive to sonidegib.


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