This is a case of a 59 year old Male, Filipino, Married, from Cebu City,
Cebu, who came in at the emergency department with a chief complaint of
a neglected, non-healing, disfiguring, ulcerating wound in the right
lateral temple. A wedge biopsy revealed Basosquamouscell Carcinoma, a
rare cutaneous, non-melanoma carcinoma. This cutaneous malignancy falls
in between the spectrum of the locally aggressive Basal Cell Carcinoma
and possess the metastatic potential of the Squamous Cell Carcinoma.
Despite the absence of an established protocol in dealing with this
malignancy, due to the rarity of the disease, surgical excision is still
suggested by most authors which was done in this case. Moh¡¯s
Micrographic surgery offers a lesser recurrence rate however due to its
unavailability a wide excision with frozen section was instead used. A
1cm surgical margin from the tumor base was utilized in the excision
resulting to a massive cutaneous defect but without bony nor deep tissue
involvement thereby needing a reconstruction. The defect spanned up to
the lateral canthus hence a full thickness skin graft was used to
reconstruct together with the Ophthalmology department. The versatility
of the cervicofacial flap was utilized with the patients laxed skin and
advancing it superiorly to cover the inferior aspect of the defect while
the contralateral subgaleal flap covered the defect of the superior
aspect of the defect. The patient successfully underwent Wide Excision
with Frozen Section with Coverage of Defect via Combined Cervicofacial
Flap and Contralateral Subgaleal Flap, and Reconstruction of Lateral
Canthus with Full Thickness Skin Graft. Succeeding post operative course
of the patient was unremarkable. |