Blog Article
Subtotal Ear Reconstruction with Alloplast
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 MoreTotal Ear Reconstruction with Osseointegrated Prosthesis
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 MoreRecurrent SCC of Nasal Tip
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 MoreUpper Chest BCC PNI
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 MoreMultiple Nasal Basal Cell Carcinomas
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 MoreLower Lip Mucosal Defect
DISCUSSION The goals of lower lip mucosal defect reconstruction include the following: Preservation of vermillion line continuity Avoiding depressions of red lip and preserving lip fullness Preservation of red lip roll (ridge) Myomucosal island flaps help achieve all of these goals. The flaps are created laterally or medially to the defect. The island can be…
Read MoreAtypical Lymphoid Infiltrate
HISTORY 49-year-old woman presents with a shiny pink papule of the left ear helix. Histology found atypical lymphoid infiltrate suspicious for a cutaneous B cell lymphoma. The area was treated with Mohs excision and closure. DISCUSSION Primary cutaneous lymphoma is a low-grade and most-common B-cell lymphoma of the skin. These are primary tumors of…
Read MoreLeft Cheek Atypical Spitzoid Nevus
HISTORY 23-year-old woman presents with lifelong history of left cheek mole changing recently. Biopsy in 8/2017 showed compound nevus with severe atypia with spitzoid features. Excision was performed on 2-9-18. The patient a history of atypical mole of the left back removed in 2017. DISCUSSION Spitz nevi are are spindle /…
Read MoreMelanoma In Situ of Leg – Mapping Excision Margins
The vexing problem of positive margins after excision of melanoma in situ has many solutions. In this article, we summarize them and rank them in the order of efficacy. Melanoma in situ excision margin guidelines range from the older 5 mm margin to the aggressive 10 mm margin of resection. 7 mm seems to…
Read MoreRed Light PDT Approval Process
We at Skin Cancer and Reconstructive Surgery Center wanted to upgrade our Photodynamic Therapy (PDT) treatment of AK’s and superficial BCC by switching from the Blu-U light to a red light source. Red light spectrum has been shown to be a deeper penetrating light for photodynamic therapy and, thus, has gained greater worldwide acceptance –…
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