A 68-year-old woman presented with a 6.4-cm2 mass on the scalp that had been present for approximately 7 years. Aside from its being annoying and an increase in its oozing and bleeding, the lesion was asymptomatic. General physical examination was unremarkable except for a single enlarged right-sided cervical lymph node and point tenderness over two ribs. An incisional biopsy of the scalp mass and an excisional biopsy of the lymph node both revealed basal cell carcinoma, micronodular histologic subtype. A chest radiograph revealed lucent rib lesions corresponding to the locations of point tenderness and consistent with bony metastases. Further workup included a CT/positron emission tomography (PET) scan that revealed two positive "hot" spots on in the right lung, superior lobe; these were also consistent with metastatic disease. Aside from mild microcytic anemia, all screening blood tests were otherwise normal. Other than surgical interventions, which medication might be most appropriate for this patient?
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