NEGLECTED ADENOID BASAL CELL CARCINOMA OF THE ARM PRESENTING WITH SECONDARY MYIASIS: A RARE CASE REPORT

Basal cell carcinoma is the most common cutaneous malignancy, typically characterized by slow growth and low metastatic potential. Among its histological variants, the adenoid type is rare and generally considered a well-differentiated form. Myiasis, defined as infestation of human tissue by fly larvae, is an uncommon complication in malignant skin lesions and is rarely documented in association with basal cell carcinoma. We report a rare case of neglected adenoid basal cell carcinoma of the upper limb complicated by wound myiasis in a 67-year-old male. The patient presented with a foul-smelling ulceroproliferative lesion containing live larvae. Following larval removal and wide local excision, histopathological examination revealed nests of basaloid cells arranged in a characteristic lace-like and glandular pattern with mucin deposition, consistent with adenoid basal cell carcinoma. Residual larval forms were noted within the tumor tissue despite prior manual removal. The postoperative course was uneventful. This case highlights an unusual and underreported association between adenoid basal cell carcinoma and myiasis, emphasizing the role of neglect, ulceration, and poor local hygiene in predisposing to secondary parasitic infestation. Early recognition of chronic skin lesions and timely intervention are essential to prevent avoidable complications and improve clinical outcomes.