Call Us Today:
949.200.1600

Posts by Simon Madorsky, MD

Subtotal Ear Reconstruction with Alloplast

subtotal-ear-reconstruction-alloplast-tpf-flap-skin-cancer-orange-county

DISCUSSION Subtotal ear reconstruction is a challenging surgical task that often requires non-traditional techniques. This particular patient was treated with an alloplastic implant and rib cartilage grafts. We utilized Medpor Helical Rim implant, a porous polyethylene material (Stryker, USA) used for microtia reconstruction. The implant was used for its elegantly curved helix. The rib cartilage…

Read More

Total Ear Reconstruction with Osseointegrated Prosthesis

total-ear-reconstruction-with-osseointegrated-prosthesis-skin cancer-orange-county

DISCUSSION Total ear reconstruction after radical skin cancer resection can be treated with prosthetic rehabilitation. Optimally, osseointegrated fixation of a prosthesis is employed. This patient was treated with complete ear amputation and post-operative radiation. His prosthetic rehabilitation was a team effort between Simon Madorsky, M.D., at SCARS Center and Mark George, D.D.S., a prosthodontist. Three…

Read More

Anticoagulant Use in Cutaneous Surgery

anticoagulant-use-in-cutaneous-surgery-scalp-squamous-cell-carcinoma-Mohs-and-reconstruction

HISTORY 87-year-old man with atrial fibrillation presented with squamous cell carcinoma in situ of scalp and forehead. Patient was treated with Mohs and reconstruction on 7-3-18. Incisional hematomas appeared 2.5 weeks post Mohs and treated with I&D. Patient continued warfarin and baby aspirin throughout treatments. DISCUSSION Anticoagulant use in Facial and Dermatologic Surgeries has become…

Read More

Leiomyoma of arm

leiomyoma-complete-excision-sarcoma-leiomyosarcoma-skin-cancer-orange-county-pathoogy

HISTORY 74-year-old man presents with 0.6cm nodule on the posterior upper arm skin .  Pathology showed atypical spindle cell neoplasm, favoring pleomorphic leiomyoma. Wide local excision was performed. DISCUSSION Leiomyoma is a tumor of smooth muscle cells. Leiomyoma of the skin usually arises from the arrector pili muscle of the hair follicles. The extent of…

Read More

Reconstructive Cases – Bilevel Grafts

Nasal-Ala-Defect-Bilevel-Skin-Graft-Orange-County-Cancer4

DISCUSSION Nasal ala skin defects can be reconstructed with skin grafts generally with excellent results. However, deeper defects of the nasal ala repaired with a skin graft may result in a depressed deformity. Contraction of skin graft healing may also cause retraction of the nasal ala, especially with deeper defects. Adding a cartilage graft  to…

Read More

Recurrent SCC of Nasal Tip

Recurrent-SCC-nose-rhinectcomy-mapping-biopsy-SCARS-center-Mohs-excision-infiltrative-squamous-cell

HISTORY 71-year-old man presents with recurrence of SCC of nose following Mohs excision on 2-9-17. Partial rhinectomy was performed with incomplete Mohs excision leaving residual positive margins due to patient’s comfort.  Two additional excisions of involved margins were done under anesthesia achieving clear margins. First stage reconstruction was performed on 4-11-18. DISCUSSION Management of a…

Read More

Upper Chest BCC PNI

Upper-Chest-BCC-perineural-invasion-Mohs-and-closure-SCARS-center-wide-local-excision-SRT-radiotherapy-orange-county-skin-cancer.JPG

HISTORY 53-year-old man presents with a 4-year-history of BCC of upper chest.  The tumor measured 12 cm x 6 cm. Wide local excision with 1 cm margins on 11/10/2017 found clear margins and perineural invasion. The nerves up to 0.23 mm were involved by tumor. The final defect was 13.5 cm x 8.3 cm.  …

Read More

Multiple Nasal BCCs

BCC-SRT-superficial-radiation-therapy-orange-county-skin-cancer-basal-cell-carcinoma

HISTORY 81-year-old man presents with 7-month history of two nasal tip and right nasal ala BCC’s. All three lesions were treated with 2 adjoining SRT fields. The course began 1-8-18 and completed by 1-26-18 after 15 treatments. DISCUSSION This patient represents an excellent candidate for radiation therapy. Electron beam radiation therapy can be used with…

Read More

Large Thigh BCC Treated with Radiation

Thigh-BCC-radiation-oncology-radiotherapy-orange-county-skin-cancer

HISTORY 92-year-old man presents with 15-year history of basal cell carcinoma on left thigh. The 9.3 cm x 8.6 cm superficial plaque was treated with electron beam radiotherapy completing 6000 cGy in 30 fractions on 3-13-2018. DISCUSSION The 6-week course of radiation was tolerated well by this patient. He had minimum oozing from previous biopsy…

Read More

Pigmented BCC of Left Neck

pigmented-bcc-neck-seborrheic-keratosis-orange-county-skin-cancer-pathology

HISTORY 81-year-old man presents with pigmented lesion on left neck. The lesion was excised with 2 mm margins. BCC was found with clear margins. DISCUSSION Pigmented basal cell carcinoma is an uncommon variant of the common skin cancer. Its behavior is that of a non-pigmented basal cell carcinoma. It can be confused with melanoma and…

Read More