Posts by Simon Madorsky, MD
Recurrent Extensive Basal Cell Carcinoma of Forehead
HISTORY 68-year-old man presented with a recurrent right forehead basal cell carcinoma. The carcinoma was previously treated with Mohs excision in 2002 and 2009. The recurrence appeared initially as superficial and was treated successfully with topical imiquimod. Deep recurrence became evident many months later. Morphology of the basal cell carcinoma was infiltrative with metatypical features.…
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Osteoradionecrosis of Skull
HISTORY 85-year-old man presented in 4/2016 with a 4 month history of a nonhealing scalp wound following excision of melanoma, radiation, and two failed skin grafts. Patient was treated with serial outer table of calvarium debridements – 4/2016, 7/2016, 11/2016. Patient had a consultation with UCI team for full thickness calvarial resection and microvascular reconstruction.…
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Lower Leg Radiation Ulcer
HISTORY 85-year-old man presented in March 2015 with a multi-year history of a non-healing right lower leg lesion. Shave biopsy found squamous cell carcinoma in situ with focal areas of early invasion. Superficial radiotherapy was prescribed at 50 kvp 5 days per week for 5 weeks ending in July 2015. Minor skin erosion present 3…
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Deeply Invasive Cheek Squamous Cell Carcinoma
HISTORY 86-year-old man presented in June 2017 with a 2 month history of squamous cell carcinoma of the left cheek. The lesion was partially treated with Mohs surgery on 6/12/2017. Due to the size of the defect and depth of extension into the ear and the parotid gland, Mohs surgery was stopped after 3 levels.…
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Sclerosing Adnexal Carcinoma of Nose
HISTORY 74-year-old man presented in June 2017 with 2-month history of scabbing of the left nose. A biopsy performed 5/11/17 revealed sclerosing carcinoma of left nose. The lesion is an 8mm plaque at the base of the left nasal ala. Mohs and reconstruction are being planned. DISCUSSION The histology of the sclerosing carcinoma is presented…
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Foreign Body Granuloma of Forehead
HISTORY 43-year-old woman presented in June 2013 with 6-month history of 1 cm forehead nodule that appeared during pregnancy. The soft lesion fluctuated in size according to the patient. Excisional biopsy performed on 6/1/17 revealed chronic granulomatous inflammation around refractile foreign material. The lesion appeared to be recurring 2 weeks post-operatively. DISCUSSION Foreign body granuloma…
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Topical 5-fluorouracil and Imiquimod Efficacy in Basal and Squamous Cell Carcinomas
HISTORY 65-year-old woman presented in January 2017 with a nasal dorsum squamous cell carcinoma in situ. The nasal lesion was treated with 6 weeks of topical 5-fluorouracil with a robust inflammatory response. A separate chin basal cell carcinoma was simultaneously treated with 6 weeks of imiquimod prescribed in February, while still undergoing 5-fluorouracil on the…
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Bilateral Nasal Island Flaps for Large Nasal Defects
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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