Immediate Umbilical Reconstruction after a Mohs Micrographic Surgery for Primary Cutaneous Adenoid Cystic Carcinoma Arising in the Umbilicus

Adenoid cystic carcinoma (ACC) is a malignant neoplasm of glands commonly occurs in salivary glands. Primary cutaneous adenoid cystic carcinoma (PCACC) is a rare form of ACC that primarily presents on the skin. Herein, we represent a rare case of PCACC occurred in the umbilicus in a 66-year-old Korean male patient. The patient visited our center with erythematous indurated patch on the umbilicus diagnosed as ACC by incisional biopsy at another center. The diagnosis of PCACC was confirmed by additional histopathologic examination and imaging study. We proceeded Mohs micrographic surgery and reconstructed umbilicus with tacked purse string suture. Local recurrence and distant metastasis were not observed during 30-month follow-up. We report this rare case of PCACC on the umbilicus so that dermatologist can aware of the rare disease. Furthermore, we recommend MMS and tacked purse string suture as effective methods for treatment of PCACC and immediate umbilical reconstruction.

Modified method for umbilical reconstruction after single-incision laparoscopic surgery / 中国现代普通外科进展

Objective:To introduce a modified method for umbilical reconstruction after single-incision laparoscopic surgery.Methods:Between June 2012 and June 2015,173 patients underwent single-incision laparoscopic cholecystectomy at our institution.All the patients adopted our modified method for umbilical reconstruction.Results:All the surgeries were successful.The umbilical incision healed well with good cosmetic result.Conclusion:The modified method for umbilical reconstruction can improve cosmesis and decrease the possibility of incision hernia after single-incision laparoscopic surgery.More studies are needed to evaluate definitive clinical advantages of this technique.

Reconstruction of Scarred Umbilicus Using an Inverted C-V Flap: A Case Report

PURPOSE: The umbilicus is an important aesthetic component of the abdomen. Its absence is both cosmetically and psychologically distressing to the patient. Umbilical reconstruction should always be aimed at creating an umbilicus of sufficient depth and good morphology with less scarring. The C-V flap developed for nipple reconstruction was used in an inverted fashion in case of umbilical reconstruction. The aim of this article is to report our experience of scarred umbilical reconstruction using inverted C-V flap. METHODS: A 22-year-old woman presented with contracted scar tissue in the umbilical region because she had undergone surgical correction of an umbilical hernia at 5 year of age. Pedicle of the inverted C-V flap was based cephalically. For enhancing depth of the umbilicus, three anchoring sutures to linea alba were done at both lateral and caudal aspects of the umbilical tube. Primary closures were done at donor sites of the V flaps and bolster sutures were done in the caudal direction of the inverted umbilical tube. RESULTS: The patient was satisfied with the appearance of umbilicus. Major complications such as dehiscence, infection, and delayed healing did not occur. CONCLUSION: The inverted C-V flap is easy and simple technique, and it can produce a satisfactory reconstruction of umbilical structure.

A Case of Immediate Umbilical Reconstruction after Surgical Excision of Keloid / 대한피부과학회지

The umbilicus is an important aesthetic component of the abdomen. Surgical procedures for omphalocele, gastroschisis, urachal cyst, and various benign or malignant tumors of the umbilical area can result in the absence of the umbilicus. Loss of the umbilicus can be an embarrassing deformity, and several methods have been used to reconstruct umbilicus, with mixed results. A 66-year-old male presented with a large mass measuring 4 x 4 cm on his umbilicus. The mass, histopathologically confirmed as keloid, developed after moxa cautery 13 years ago. Complete surgical excision resulted in a large defect, and immediate umbilical reconstruction with purse-string suture technique was done. The patient was seen at follow-up 6 months later, and the umbilicus had a satisfactory appearance.

Immediate Umbilical Reconstruction after Removal of Umbilicus due to Urachal Cancer: Defatting, Anchoring and Purse-String Suture

Reconstruction of the umbilicus is not a frequent event. Umbilical restoring should always be aimed at creating an umbilicus of sufficient depth and good morphology(circular and cylinder shape) with less scarring. A wide range of techniques has been described to reconstruct neoumbilicus; nevertheless, a perfect result is difficult to obtain. I provide another alternative to reconstruct the umbilicus using defatting, anchoring and purse-string suture. The important steps are the following; the first step is defatting of 2.0cm umbilicus' circle. The second step is to umbilical fixation to the fascia wall using anchoring suture. The third step is purse-string suture to decrease new formative umbilicus and to make the circular and cylinder shape umbilicus. The author's method is a simple, easy and useful technique and renders better aesthetic result. So, I reviewed two cases and discussed the literatures.

Immediate Umbilical Reconstruction for Urachal Cancer

The umbilicus is a central line of abdomen and can be an important aesthetic interest in the abdomen wall, so its loss can be a source of psychological distress. Many techniques for reconstruction of a lost umbilicus have been described, however none has achieved a perfect result. There are few reports that describe the procedure for immediate reconstruction of umbilicus after surgical ablation except Miller's Iris technique. We have performed umbilical reconstruction right after the umbilicus was resected during the surgery. The patient was a 34 year old man with urachal cancer, who wanted to have his lost umbilicus reconstructed immediately for personal, social, and aesthetic reasons. We tried immediate reconstruction with modified iris technique. Using three local flaps, we fixed the central portion of inferior flap at the area of 1 cm below umbilical defect on linea alba. The neoumbilicus retained in its depth and natural shape. This technique is considered to be simple and draw good results.