The authors report on 3 cases of facial recurrent sclerosing basal cell carcinomas requiring large ablative cranio facial surgery and reconstruction involving regional or even free flaps. Special emphasis is made on the aggressive behavior of this specific histological form and on the necessity of an early diagnosis, a radical initial treatment and a close life time follow-up. Surgery with careful histological control of the margins is the treatment of choice whereas radiotherapy is an alternative for small lesions or nonsurgical patients. This early and aggressive therapeutic management is essential in order to avoid recurrences often requiring disfiguring surgery.
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