This study evaluated the use of neoadjuvant vismodegib (Hedgehog pathway inhibitor) to reduce tumor burden prior to Mohs micrographic surgery for periorbital basal cell carcinoma. The approach aimed to decrease defect size and minimize the need for complex periorbital reconstruction. The results demonstrated significant tumor volume reduction with neoadjuvant vismodegib, allowing more conservative surgical resection while maintaining oncologic outcomes.

Neoadjuvant vismodegib can significantly reduce BCC tumor volume, leading to smaller surgical defects in periorbital tumors.

This approach may simplify periorbital reconstruction by reducing defect complexity while maintaining clear margin rates.

Potential limitations include medication side effects, incomplete pathologic response, and the theoretical risk of skip areas.