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Vismodegib is useful to treat locally advanced or metastatic basal cell carcinomas (BCCs),1 but to our knowledge, its use as a neoadjuvant to shrink BCCs before surgery has not been reported. This case illustrates the role of vismodegib as a neoadjuvant agent. In addition, this case highlights the fact that a patient with Gorlin syndrome can develop resistant BCCs while taking vismodegib, a phenomenon not widely recognized although recently reported.2

jama dermatology

Surgical Excision After Neoadjuvant Therapy With Vismodegib for a Locally Advanced Basal Cell Carcinoma and Resistant Basal Carcinomas in Gorlin Syndrome