Case Report
An 88-year-old patient with a history of epidermoid carcinoma on the left cheek skin resected 12 years ago. He had a lesion in the right nasal wing with full-thickness perforation and the presence of an obstructing tumor in the entire right nostril, invading the septum for the last 2 years. (Fig. 1, Fig. 2.)
The CT reported tumor invasion of the nasal wing, septum, right nasal dorsum, right inferior turbinate in its frontal area; it did not involve nasal floor, maxilla or paranasal sinuses. It was staged as T3N0M0 according to AJCC eighth edition of primary cutaneous carcinoma. A biopsy was taken with histopathological results of moderately differentiated squamous cell carcinoma.
Total rhinectomy was scheduled, which was performed without complications, obtaining a pathology result that confirmed moderately differentiated, invasive and ulcerated squamous cell carcinoma of 3.3 x 2.3 cm deep that invaded the nasal mucosa up to the elastic cartilage of the nasal septum and negative skin edges for neoplasia (T3N0M0). (Fig. 3). The patient received adjuvant radiotherapy (45 Gy in 15 sessions) with no complications nor recurrence due to clinical manifestations or PET-CT during 1 year follow-up.
4.5 months after the rhinectomy, the patient showed healing of the skin and mucosa of the nasal defect. Therefore the reconstructive surgery department evaluated a nasal prosthesis placement. Maxillofacial department was in charge of the prosthesis impression. The implant- retained prosthesis was made out of silicone, mimicked the natural skin of the patient and was chemically attached. (Fig.4)