Basal cell carcinoma of the nose tip: A case report of precision surgery and local flap reconstruction

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. •Basal cell carcinoma can sometimes present with atypical clinical features, resembling benign lesions•Surgeons should cautiously excise benign tumors with adequate margins to avoid positive resection edges•Random-pattern local flaps remain a viable option for reconstructing large defects in the nasal tip area.