The use of nail enfolded flaps for reconstruction of full-thickness ala nasi defects: an early report of experience.

The most common etiology of nasal defects that require reconstruction is basal cell carcinoma, as well as squamous cell carcinoma and melanoma. In reconstructing full-thickness ala nasi defects following excision of basal cell carcinomas, we present our technique of the nail enfolded local flaps which involves the harvesting of the nail plate and placing it to serve as a supporting component. In four patients, the nail plate grafts are inserted into various local flaps, and used for reconstruction of full-thickness ala nasi defects. Lining deficiencies of the alar lobule were resurfaced with skin grafts. None of the cases experienced skin graft loss or nail plate exposure. The nail graft prevented alar collapse by supporting the nasal airway. This technique discards the need for a second operation.

A primitive neuroectodermal tumor on the face: case report.

In 1918, Stout defined the lesion in which small round cells originating from the ulnar nerve formed a rosette as neuroepithelioma. It was claimed that this tumor originated from neuroectodermis and was different from the classical neuroblastoma. The term primitive neuroectodermal tumor (PNET) involves a group of tumors of the soft tissue originating from neural crest and resulting from the brain, spinal cord and branches of the sympathetic nervous system. Extracranial primitive neuroectodermal tumors originate from neural crest cells outside the sympathetic and central nervous system. PNET also has some distinctive histological, immunohistochemical and ultrastructural features. It is usually encountered in children and young adults; most frequently located in thoracopulmonary region (Askin's tumor). The second most commonly involved body part is the extremities. It is very rarely located on the face. PNET is an aggressive tumor. In fact, the disease has a rapid progression, causes local or distant metastases and 50% of the patients die within two years of the presentation. It is treated with aggressive surgery as well as chemotherapy and radiotherapy. In this report, we presented a case of PNET located on the right cheek with multiple distant metastases. Clinicians should be on alert when treating facial tumors, not to skip PNET, which is a very aggressive one.