Nguyen Lam Van, Nguyen Giau Huu, Ngo Minh-Phuong Tri, Pham Minh-Chien, Vo Hau Thi, Nguyen Chon Thanh
Department of Aesthetic and Plastic Surgery, Can Tho University of Medicine and Pharmacy, Can Tho, Viet Nam.
Department of Aesthetic and Plastic Surgery, Can Tho University of Medicine and Pharmacy, Can Tho, Viet Nam.
Int J Surg Case Rep. 2025 Jan;126:110737. doi: 10.1016/j.ijscr.2024.110737. Epub 2024 Dec 11.
Basal cell carcinoma is the most common non-melanoma skin cancer, tightly connected to ultraviolet exposure, and typically occurs on sun-exposed areas, including the nose. Reconstructing defects in the nasal tip following the removal of basal cell carcinoma lesions presents significant challenges, requiring a balance between completely removing the cancerous cells and achieving an optimal aesthetic result, especially since this area is central to the face.
We present the case of a 62-year-old male patient with a 2 × 3 cm tumor located at the nasal tip, initially diagnosed as a benign vascular tumor based on clinical examination and imaging results. The tumor had been progressively growing over the past three years, interfering with the patient's daily activities, and prompting his desire for its removal. A surgical excision of the tumor was performed, using a local flap incorporating Burrow's triangles to minimize skin tension and optimize aesthetic outcomes. The patient made a good recovery, and the wound healed well. However, histopathological analysis revealed residual tumor cells at the resection margin.
Reconstructing defects after excising basal cell carcinoma from the nasal tip is challenging and tumor removal must ensure complete cancer excision while preserving the nasal structure. Local flap reconstruction is often preferred for better cosmetic results.
Careful planning and wide excision margins are crucial, as basal cell carcinoma can resemble benign lesions, as shown in our case.
基底细胞癌是最常见的非黑素瘤皮肤癌，与紫外线暴露密切相关，通常发生在包括鼻子在内的阳光暴露部位。在切除基底细胞癌病变后重建鼻尖缺损面临重大挑战，需要在完全清除癌细胞与实现最佳美学效果之间取得平衡，尤其是因为该区域位于面部中央。
我们报告一例62岁男性患者，其鼻尖有一个2×3厘米的肿瘤，根据临床检查和影像学结果最初被诊断为良性血管肿瘤。该肿瘤在过去三年中逐渐生长，影响患者的日常活动，促使他希望将其切除。采用包含布罗三角的局部皮瓣进行肿瘤手术切除，以尽量减少皮肤张力并优化美学效果。患者恢复良好，伤口愈合良好。然而，组织病理学分析显示切除边缘有残留肿瘤细胞。
从鼻尖切除基底细胞癌后重建缺损具有挑战性，肿瘤切除必须确保完全切除癌症，同时保留鼻结构。局部皮瓣重建通常更受青睐以获得更好的美容效果。
如我们的病例所示，由于基底细胞癌可能类似良性病变，仔细规划和广泛的切除边缘至关重要。
