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Giant basal cell carcinoma (GBCC) is a rare and more aggressive variant of basal cell carcinoma. We present a case of GBCC with an overview of the challenges it presents.A man in his 60s presented to the tertiary care unit with a history of an ulcer over the posterior aspect of his left heel for the past 1 year. Examination revealed an ulceroproliferative lesion of 10×8 cm on the posterior aspect of the left heel and lower Tendo-Achilles region. A wedge biopsy of the lesion was performed twice, which demonstrated basal cell carcinoma. The patient underwent excision of the lesion with 10 mm margins. A split-thickness skin graft was placed and secured over the resultant wound with the application of a negative pressure wound dressing.The correlation between tumour size and tumour behaviour is examined. Additionally, the significance of tumour location, width of margins, incidence recurrence or metastasis is also studied., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

Competing Interests: Competing interests: None declared.

Competing Interests: Competing interests: None declared.

After 2 years of holistic self-treatment on his home island, an elderly Samoan man presented with a painful, hyperpigmented mass on his left heel. Physical examination revealed a black, friable tumour with necrotic tissue and superficial ulcerations with no other associated symptoms. Further investigation revealed that the mass was invasive. The tumour was treated with resection and a final diagnosis of acral lentiginous melanoma, stage T4b was made. Poor access to care and screening services are large barriers to care for minorities and patients with low socioeconomic status. Once access is obtained, however, patient compliance is not guaranteed. Healthcare practices often clash with societal beliefs, and so patient education regarding their disease and its possible progression, along with treatment options, is important. Furthermore, a lack of ethnically diverse physicians contributes to low cultural competency during interaction with patients from minorities, resulting in poor communication and low patient satisfaction., (2015 BMJ Publishing Group Ltd.)

Lipoma is rarely found in the foot. It is usually asymptomatic although sometimes can present with pain. We report a case of lipoma of the sinus tarsi presenting with functional instability.