What is best treatment for basal skin carcinoma that was previously excised 25 years ago but is now 3.9cm x 2.5cm x 3.9cm located in the left orbital and left nasal areas beneath but not connected to the lacrimal gland? Patient is 88 yrs. old in otherwise good health and weighs 82 lbs and is 4'11'' tall. Do we go to a plastic surgeon, a Mohs surgeon, a otolaryngologist plastic surgeon, ENT? Who is best to perform the surgery if surgery is your recommendation? Choices we were given was to do nothing, have surgery, do radiation. Patient is having pain we assume caused by the tumor crowding the eye in the orbital. Patient has high tolerance for pain and is not one to go to the doctor or take medicine. Patient is now taking aspirin daily for pain.