Squamous carcinoma of the nasal vestibule - An analysis of five cases and literature review

Five examples of squamous carcinoma of the nasal vestibule are reported. Possibly because this keratinizing tumor is histopathologically identical to squamous cancer in other locations, reports of this tumor in the pathology literature are uncommon. The patients were four men and one woman, of whom three men were smokers, although there are no consistent published associations with any environmental toxins to determine patients at risk. All five patients had localized disease treated by combinations of surgery and radiation therapy. Flap reconstructions and skin grafting were used in three patients; two patients underwent nasal amputations. Three patients also received postoperative irradiation. Three patients experienced recurrences from 2 to 13 years after the original treatment; there were no deaths related to this tumor. Histologically, these are typically ulcerated tumors seldom showing evidence of in situ carcinoma. Surgical margins of excision were positive or close in three cases but did not influence the chronic course of the disease. No clinical tumor staging system is generally accepted, and it seems that the prognosis for localized disease is good irrespective of clinical stage. Aggressive features, including penetration of cartilage and invasion of overlying skin, may be impressive, but do not preclude long-term survival if bulk disease can be surgically removed.