Archive for May 2017
EXTENDED LATERAL NASAL ISLAND FLAP
Discussion Here we present three cases of extended lateral nasal island flap. These flaps are based on the branches of angular artery that include alar artery and the lateral nasal arteries. The flap is an excellent way of reconstructing nasal tip, dorsum and ala defects up to 1.5 cm in diameter. The release of the…
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DEEP NECK BASAL CELL CARCINOMA RECURRENCE – FOLLOW UP
Initial resection sparing facial nerve branches Resection of additional positive margins (the submandibular gland and the mandible are visible), second excision of additional margin. HISTORY 63 year old man presented with a 5-year history of a lesion in the left anterior neck. The lesion was diagnosed as basal cell carcinoma and excised in 2012, but it…
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STAGING OF RECURRENT EXTENSIVE BASAL CELL CARCINOMA OF THE FOREHEAD
HISTORY This 68-year-old man presented with a recurrent extensive right forehead basal cell carcinoma eight years after previous Mohs excision. The lesion itself is palpable as it extends for approximately 5 cm. The extent appears to be subcutaneous for approximately 1.5 cm past a visible plaque. The histopathology shows this to be a nodular type…
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FIELD CANCERIZATION WITH BASAL CELL CARCINOMA
2012 Radiation Simulation Persistent cheek recurrence of BCC at edge of flap recent CT showing resected right temporal bone with overlying flap and evidence of deep tumor HISTORY This 69-year-old man presented with greater than 25-year history of multiple basal cell carcinomas of the face and neck. His most problematic cancer has been in the…
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LOWER LID CARCINOMA
HISTORY This 84 year old man was initially seen with a large left facial lesion. Biopsy diagnosed basal cell carcinoma in 3 locations of biopsy. The patient was reluctant to undergo a surgical excision and reconstruction. Vismodegib (Erivedge) was used as primary treatment. Patient completed a 4 month course of 150mg daily vismodegib dose. He…
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CHEEK NODULE
HISTORY 57 year old woman presented with a 6 month history of a dense nodule in the subcutaneous malar cheek. Biopsy on 3/31/2017 revealed a foreign body reaction granuloma with polarizable foreign body. Kenalog injection of the mass was performed a few months before without improvement. There is no history of Sculptra or other fillers…
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ALAR ISLAND FLAP
Discussion This month’s reconstructive case series addresses a small alar island flap for reconstruction of smaller defects of the ala. The alar island flap is based on lateral nasal artery and alar artery arising from the angular artery of the face. Wide release of the flap is necessary both in subcutaneous plane and in submuscular plane separating if…
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MEDIAL CANTHUS BASAL CELL CARCINOMA FOLLOW UP
HISTORY 91 year old man presented with a recurrent right medial canthus BCC that was previously treated with 45 days of radiation (SRT at Hoag Hospital). Biopsy showed infiltrative sclerosing basal cell carcinoma with focal perineural invasion. MRI in December of 2016 showed the mass was fixed on the lamina papyracea adjacent to the medial…
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