Morphoeic BCC with extensive Perineural Invasion - Have now had very invasive Mohs surgery. (photo)

Single excision surgery was performed on me on a visible BCC in June 2014 on my nose. The subsequent histology on specimen showed the above. Further I have discovered that it was still present on the lateral margin 12 to 3 o'clock as well as the deep margin. I was sent home and declared cancer free on 3 follow ups over 18 months. Have now had very invasive Mohs surgery. My question? Do I have a case against this surgeon and what damage could this extensive PNI have done over the last 18 months?

Doctor Answers 1

Extensive Mohs Defect

 Morpheaform (sclerosing) basal cell cancers, especially perineural ones, are typically much more extensive than they appear from the surface. Your experience is all too common with this type of cancer. All Mohs surgeons have encountered this problem - what looks like a tiny bump on the surface turns out to leave a very large defect.
So sorry that you had to go through what must have been a frightening experience.

Austin Dermatologic Surgeon
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