Basal Cell Carcinoma on Nostril Treated with Two-Stage Mohs Surgery, Preserving Appearance

(CNA, reporter Shen Pei-yao, Taipei, July 1) A 36-year-old man, Mr. Lin, initially thought a spot on his nostril was just a patch of white discoloration, but was diagnosed with basal cell carcinoma. Traditional surgery could have affected his appearance. Taipei Veterans General Hospital employed "slow Mohs micrographic surgery" in two stages to precisely and completely remove the cancerous cells, preserving his nostril and cartilage, with good post-operative recovery.

Dr. Lee Cheng-yuan from the Department of Dermatology at Taipei Veterans General Hospital, who treated this case, described slow Mohs micrographic surgery today as "slow work yields fine results." In a media interview before the successful clinical experience presentation, he pointed out that traditional skin cancer surgery typically removes an additional 0.5 to 2 cm "safety margin" around the visible tumor to prevent recurrence.

However, Dr. Lee stated frankly that for tumors located on the face, such as around the eyes, nose, lips, or on the soles of the feet, extensive excision can often affect the patient's appearance, limb function, and quality of life.

Dr. Lee's presentation explained that "Mohs micrographic surgery," internationally recognized for its high cure rate, allows for examination of tumor margins during surgery. However, traditional cryostat sectioning, while completed the same day, has limited diagnostic capability for high-grade, ill-defined, or recurrent skin cancers.

Taipei Veterans General Hospital's Department of Dermatology has introduced "slow Mohs micrographic surgery," which uses higher-detection "paraffin-embedded tissue sections." Dr. Lee said that Taipei VGH has accumulated over a hundred cases. The "slow" aspect means patients need to wait 3 to 5 days for pathology results with a dressed, open wound, but this provides clearer cellular images. If residual lesions are found in the pathology, subsequent multi-stage tumor excisions can be performed to ensure no skin cancer cells remain.

Mr. Lin, 36, shared his treatment journey. A hard white lump had been growing on his left nostril for 4 to 5 years. He initially thought it was a common skin lesion. It wasn't until last year that it gradually enlarged and bled, prompting him to seek medical attention. Biopsy confirmed it to be a high-risk, micronodular basal cell carcinoma. As the cancer cells had extended downwards like tree roots, he might have needed his nostril and nasal cartilage removed. After two stages of slow Mohs micrographic surgery, the cancer cells were successfully and completely removed, preserving the appearance of his nose.

Dr. Lee added that slow Mohs micrographic surgery is currently covered by National Health Insurance. As it requires cross-team collaboration from pathology and plastic surgery, not all hospitals are equipped to perform it. Most patients are also advised to be hospitalized for wound care and to await pathology results.

He reminded the public that if they notice any "ABCDE" warning signs in moles or skin patches, including Asymmetry, Border irregularity, Color variation, Diameter larger than 0.6 cm, or Evolution (rapid change over time), they should seek medical examination as soon as possible for early diagnosis and treatment. This can improve cure rates and minimize the impact on appearance and function. (Editor: Yang Sheng-ru) 1150701

Stand with facts, your every donation is a force to protect the freedom of the press.

Download the CNA "One News" app for real-time updates.

This website's text, images, and videos may not be reproduced, publicly broadcast, or publicly transmitted and used without authorization.