Aggressive Basal Cell Carcinoma in the Nasal Region

• Published in: Journal of dermatology 2005-06, Vol.32 (6), p.424-431
• Main Authors: Motomura, Hisashi, Taniguchi, Toshiko, Harada, Teruichi, Muraoka, Michinari, Ishii, Masamitsu
• Format: Article
• Language: English
• Subjects: Aged; aggressive BCC; Biopsy, Needle; Carcinoma, Basal Cell - pathology; Carcinoma, Basal Cell - surgery; Female; Follow-Up Studies; Humans; Immunohistochemistry; Magnetic Resonance Imaging; Male; Middle Aged; Mohs Surgery - methods; MRI; nasal region; Neoplasm Invasiveness - pathology; Neoplasm Staging; Nose; Reconstructive Surgical Procedures; safety margin; Skin Neoplasms - pathology; Skin Neoplasms - surgery; Surgical Flaps; Tomography, X-Ray Computed; Treatment Outcome
• ISSN: 0385-2407; 1346-8138
• DOI: 10.1111/j.1346-8138.2005.tb00773.x

It is extremely rare for basal cell carcinoma (BCC) to metastasize, so it is often only simply excised. However, BCC may cause severe local tissue destruction, which often extends to surrounding muscle, cartilage, and bone; it is then termed “aggressive” BCC. We evaluated the safety margin and the reconstruction method in four cases of nasal BCC that were diagnosed as aggressive BCC histopathologically or by imaging, including magnetic resonance imaging (MRI) and computerized tomography (CT) and then treated by excision. The results showed that the larger the aggressive BCC was, the smaller the histopathological safety margins became. The lateral nasal region was classified into three regions, and individual reconstruction was performed according to anatomical unit, resulting in favorable outcomes. Nasal BCC should be closely examinated, it requires a careful treatment strategy similar to that for other malignant skin tumors.