Successful reconstruction using three flaps combination after wide excision due to basosquamous carcinoma: A case report

INTRODUCTION

Basosquamous carcinoma (BSC) is an uncommon and malignant subtype of non-melanoma skin cancer. It has features that are halfway between basal cell carcinoma (BCC) and squamous cell carcinoma (SCC).

CASE PRESENTATION

An 87-year-old female presented with a lesion on her left cheek, nasal ala, medial canthal area, and eyelids. After investigations, which included biopsies and a computed tomography scan (CT), surgery was decided upon to completely remove the mass. A 5 × 4 cm defect after the surgery was reconstructed by mobilizing three flaps, including the McGregor flap, VY glabellar flap, and nasolabial laterally based cheek flap. The excisional biopsy detected malignancy at the lateral border of the upper lid, which led to the patient undergoing surgery to remove the tumor formation. After the second surgery, the histopathology confirmed no malignancy. The patient had functionally and aesthetically pleasing results, preserved eyelid movement and visual field. No surgical complications or recurrences occurred within the first year after the surgery.

DISCUSSION

BSC is a neoplasm without well-defined histologic characteristics or standardized treatment procedures compared to other non-melanoma skin cancers. However, several studies recommend using wide excision. In our case, Reconstructing the area was challenging due to important anatomical structures and finding tissue that matches the desired appearance, while preserving functional and aesthetic results.

CONCLUSION

In this case report, we highlight the value of reconstructing face defects after wide excision due to BSC using three flaps.