Vismodegib therapy for large basal cell carcinoma of the midface with orbital involvement

A 79-year-old farmer was admitted to the emergency surgical ward after falling and hitting the back of his head. Cerebral hemorrhage was ruled out, but a large tumor in the midface was discovered incidentally. After being discharged from surgery, the patient presented to our dermatological oncology outpatient clinic for the first time.

The patient had first noticed a small lump on the bridge of his nose 10 years ago. Since then, it had steadily grown in size. As the tumor had already displaced his left eye and threatened to spread to his other eye via the bridge of his nose, the patient sought medical attention for the first time in 10 years because he and his family were concerned about his eyesight.