Negative surgical margin before reconstruction in the treatment of advanced nasal basal cell carcinoma

Abstract

25% of basal cell carcinoma (BCC) occurs in nose. The recently accepted treatment includes wide excision with safety margin of 4 mm of clinically normal skin. 3 major points in the treatments are clearance, cosmetic and functional value. Often, due to its central location and delicacy of the surrounding tissue makes it hard to achieve standard surgical margin for lesions located in nose. The size and the depth of the lesion may complicate therapy. These 3 cases reporting large lesion BCC treated with multiple wide excisions before underwent reconstruction. Case 1 and 2 had 3 and 4 time excisions due to failure of gaining negative margin in the previous surgeries. Multiple surgeries were preferred for although it delayed reconstruction, from oncologic point of view it is principle to accomplish perfect clearance of the tumor. Recurrences do not happen on big percentage of cases with positive margin, but may lead to even more complicated reconstruction that compromises patient health. The 2 cases gave satisfactory results with no recurrence within 3 years after surgery.