Radical Excision and Staged Paramedian Forehead Flap Reconstruction for Locally Advanced Basosquamous Carcinoma of the Nose: A Case Report
Year: 2026
Type: article
Study design: Case Report
Abstract: Basosquamous carcinoma is an uncommon and locally aggressive cutaneous malignancy with histological features of both basal cell carcinoma and squamous differentiation. Extensive nasal involvement with cartilage invasion presents significant oncologic and reconstructive challenges. Radical excision followed by staged paramedian forehead flap reconstruction remains a reliable treatment for large composite nasal defects. A 72-year-old Nepalese man presented with a 12-month history of a progressively enlarging ulceroproliferative lesion involving the left nasal ala, dorsum, tip, and sidewall, resulting in marked destruction of the external nose. Contrast-enhanced computed tomography demonstrated invasion of the nasal cartilaginous framework and adjacent nasal bone without regional or distant metastasis. The patient underwent radical wide local excision followed by immediate staged paramedian forehead flap reconstruction. Final histopathology revealed infiltrative basosquamous carcinoma measuring 3 cm with 2 cm depth of invasion, involvement of the underlying nasal cartilage, negative peripheral margins (closest 4 mm), and a free deep margin (1 mm). At 6-week follow-up, the flap remained completely viable with satisfactory wound healing, restoration of nasal contour, and no clinical evidence of local recurrence. Radical oncologic resection combined with staged paramedian forehead flap reconstruction achieve successful tumor clearance and excellent early functional and aesthetic outcomes in this patient with locally advanced nasal basosquamous carcinoma. Histologically negative margins and favorable short-term follow-up support this approach for extensive nasal defects
Source: Nepalese Journal of Cancer
Authors: Amar Shrestha, Abishesh Shakya
Institution: B.P. Koirala Memorial Cancer Hospital
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7225093139