Malignant tumors in the skull base region of the nasal cavity and sinuses are of complex tissue origin, adjacent to important anatomical structures such as the skull base and orbit, and closely related to the anterior skull base, meninges, olfactory area, optic nerve, pituitary gland, trigeminal nerve, and abducens arteriosus nerve. These tumors, however, often require complete resection in order to improve the cure rate of the tumor and reduce surgery-related complications to save the patient’s life. Zhang Weitian, Department of Otolaryngology-Head and Neck Surgery, Shanghai Sixth People’s Hospital Introduced an exceptional case that could not be controlled after 2 surgeries in a well-known local tertiary care hospital. The patient, male, was 46 years old. The patient’s family was almost desperate when he came to the clinic. The tumor invaded the anterior skull base and penetrated the bone plate; it reached the forehead subcutaneously. Posteriorly, it invaded the olfactory region and the anterior skull base, in close relationship with the dura mater (Figure 1); laterally, it invaded the left orbital area (Figure 2) Inferiorly, it invaded all the way to the septal sinus nasal cavity. We carefully planned the surgical plan, including the decision to use an open coronal incision; whole resection of the tumor in the forehead, between the eyebrows, anterior skull base, and in the orbital nasal cavity, followed by reconstruction of the facial contour using titanium mesh and application of a mucosal flap with a vascular tip to repair and reconstruct the skull base. The surgery was performed in 7 hours and was successful. The patient was discharged 2 weeks after surgery with a normal facial profile and no residual tumor. Happy to go home. As in Figure 3, the postoperative coronal MRI image looks at the total resection of the tumor in the skull base, nasal cavity and orbit; as in Figure 4, the postoperative sagittal MRI shows the skull base tumor, the invaded frontal bone has been resected and the profile has titanium mesh reconstruction; as in Figure 5, the postoperative endoscopic observation shows a clean nasal skull base area with no tumor residue and a solid skull base reconstruction.