Peculiar Patterns of Spread of Nose Vestibule Malignancies

Nose vestibule malignancies must be considered nasal primaries, but they present clear striking peculiarities compared to primaries arising from nasal cavity proper and ethmoid (which are included in the same T classification criteria). One of such peculiarities is the early straightforward invasion of the skin, so that they are often mistaken for skin primaries, and on the other hand, every lesion of the nasal and perinasal skin should be evaluated by the otolaryngologist to exclude a nose vestibule primary. In general, the patterns of spread of nose vestibule SCCs depend on anatomical and histological characteristics of the three linings that compose the vestibule (cartilages, skin, and mucosa) and on the wall (medial, lateral, inferior) of the vestibule primarily involved. Deep knowledge of such peculiar and specific patterns of spread is fundamental to properly classifying and treating these malignancies.