Remarkable Response to Vismodegib in a Locally Advanced Basal Cell Carcinoma on the Nose

Basal cell carcinoma (BCC) is the most common cancer in the world, and its incidence continues to rise. Known risk factors for BCC include chronic UV exposure, advanced age, and genetic predisposition. A large majority of BCC cases have an altered Hedgehog (Hh) signaling pathway. When a large BCC develops on the face, it can pose unique treatment challenges due to functional and cosmetic considerations-even with Mohs micrographic surgery (MMS). Traditional treatment options may be limited, prompting the use of targeted therapies such as vismodegib for unresectable cases. Vismodegib, an Hh inhibitor, is approved by the US Food and Drug Administration for treatment of locally advanced or metastatic BCC. This case report details the successful management of a large BCC on the nose of an elderly patient using vismodegib.