A case of recurrent porocarcinoma of the scalp requiring scalp reconstruction

Eccrine porocarcinoma (EPC) is a rare malignant tumour, first reported by Pinkus and Mehregan in 1963. It can develop from the eccrine duct epithelial component or transform from an underlying eccrine poroma. The tumor usually presents as an exophytic growth and has a female predilection. Rarely it can occur in scalp, face, ear, genitalia and eye lids. Treatment modalities have included standard excision, Mohs micrographic surgery, chemotherapy, and radiation therapy. Therapy of choice is surgical excision with clear margins with 70-80% cure rates. Chemotherapy is of no known significance and radiation might help in selective cases. Majority of cases are managed with excision and closure of defects but in selective cases there may be need to reconstruct the scalp defects. The methods of reconstruction may be local flaps, free tissue transfer and partial/full thickness skin grafts. Regional flaps are very useful in patients requiring cover of large defects.

Clinical application of superior trapezius myocutaneous flap for immediate restoration of tongue defect after the operation of tongue squamous cell carcinoma / 重庆医学

Objective To evaluate the clinical effect of superior trapezius myocutaneous (STM) flap with thetransverse cervical artery (TCA) in reconstruction of tongue defects immediately after the neck dissection of tongue squamous cell carcinoma.Methods From January 2013 to December 2015,the combined radical neck dissection was carried out in 16 patients of tongue squamous cell carcinoma in our institute.All tongue defects were reconstructed by the STM with the TCA.The donor sites were closed directly without skin grafting.Results All flaps survived,and the success rate was 100％.Primarily,the morphology and function of the reconstructed tongues were dissatisfactory.Three months to one year after operation,the mucosalization of flaps appeared,and the functions of speech,mastication and swallowing improved obviously.Conclusion The STM with TCA is one of the ideal flap for reconstructing the postoperative defects of tongue squamous cell carcinoma.

Preliminary study on superior trapezius myocutaneous flap through accessory nerve anastomosis in reconstructing the tongue defect after the operation of tongue squamous cell carcinoma / 重庆医学

Objective To explore the clinical effects of superior trapezius myocutaneous flap through accessory nerve anastomosis in immediately repairing the tongue defect after tongue squamous cell carcinoma operation.Methods Six cases of tongue squamous cell carcinoma diagnosed by pathology in the Maxillofacial Surgery Department of the Affiliated Stomatological Hospital of Chongqing Medical University from January 2015 to December 2016 were collected and Performed the tongue-neck combined radical operation.The superior trapezius myocutaneous flap simultaneous repair of tongue defect with accessory nerve and hypoglossal anastomosis was adopted during operation.The wound surface of donor site was directly sutured without skin grafting.Results All flaps survived.After 6 months to one year,the flap became mucolized,the surface of flap was similar to the normal oral mucosa with good character.The movement of reconstructed tongue mainly depended on the movement of residual tongue at early stage (within postoperative 3 months).After 6 monthsthe reconstructed tongue had obvious mobility,but the flexibility was poorer than that of the uninjured side,and the patient was satisfied with the language and swallowing function.Conclusion The superior trapezius myocutaneous flap through the accessory nerve anastomosis is one of the ideal skin flaps for repairing tongue defect after e tongue squamous cell carcinoma operation.