Basal cell carcinoma is the most common human malignant tumor, and is most frequently located on the face. The excision of lesions greater than 2 cm from the upper lip requires a complex and difficult reconstruction. The authors describe the case of a 74-year-old female patient who had a nodular basal cell carcinoma of approximately 2 cm on the upper lip, which crossed the vermillion border. The lesion was excised and the reconstruction carried out using a nasolabial transposition flap with an inferior base. Histologic analysis showed there was a complete resection, with a satisfactory aesthetic result after one year.

Keywords: CARCINOMA, BASAL CELL, LIP, RECONSTRUCTIVE SURGICAL PROCEDURES

Lip tumors account for 15% of head and neck neoplasias. When the defect is greater than one third of the lip, the Camille Bernard’s flap is suitable for the reconstruction of the lower lip. The present study describes a case with a satisfactory outcome, where functional, aesthetic, and sensory preservation of the lower lip was obtained by using this technique in its surgical reconstruction, following excision of a locally advanced tumor.

Keywords: CARCINOMA, BASAL CELL, RECONSTRUCTIVE SURGICAL PROCEDURES, LIP NEOPLASMS

The reconstruction of surgical defects generated by the excision of nasal tumors is a challenge for dermatologic surgeons due to the rigid structure and low mobility in the region. Among the alternatives to repair these defects is the pedicled frontal interpolation flap, especially where there is involvement of two or more aesthetic units of the nose. The present study reports the case of a patient with basal cell carcinoma involving the alae, tip, and columella of the nose, in which surgical repair after resection was carried out with pedicled frontal interpolation flap or medial frontal flap with excellent cosmetic results.

Keywords: CARCINOMA, BASAL CELL; SURGICAL FLAPS; RECONSTRUCTIVE SURGICAL PROCEDURES

Basal cell carcinoma is the most common skin cancer and can result in significant morbidity if not completely excised. The present article describes a case of nasal reconstruction using the Rieger flap, after the excision of a basal cell carcinoma, which yielded good aesthetic results. The authors have chosen this flap due to the fact that the donor area contains an abundant supply of tissue to cover surgical wounds, which is of a good color and texture for the upper region of the nose.

Keywords: CARCINOMA, BASAL CELL; RECONSTRUCTIVE SURGICAL PROCEDURES; NOSE NEOPLASMS; SURGICAL FLAPS.

Eccrine spiradenoma is a rare benign adnexal epithelial neoplasm characterized by a bluish-pink, slow-growing solitary nodule, coursing with paroxysmal pain, mainly in young adults. It is most commonly located in the trunk and extremities. Bleeding and/or ulceration are common in the giant vascular variant, which is characterized by a size greater than 2 cm in diameter and a high degree of vascularization seen on histology. Its clinical characteristics are unspecific and require biopsy with histological analysis for diagnosis. Its histology presents one or more basophilic intradermal lobules enveloped in a fibrous capsule without connection to the epidermis. It presents two types of cells: small cells with dark nuclei in the periphery and large cells with light nuclei in the center. An accurate diagnosis is important due to the fact that it can develop into a potentially fatal malignancy - which is a rare phenomenon and occurs most often in the multiple variant. A rare case of eccrine spiradenoma in the abdomen with bleeding associated is described in the present paper, as well as a discussion on possible treatments.

Keywords: ECCRINE SPIROADENOMA, BENIGN EPITHELIAL NEOPLASIA, SEBACEOUS GLANDS

Lip cancer corresponds to 25-35% of all oral cancers. Squamous cell carcinoma is the most common histological type in this location (95%). Various wound reconstruction options are described for the exeresis of this type of tumor in the lower lip - the choice depending on the surgeon's experience and the proportion of the final defect regarding the dimensions of the lip. The present article describes the case of a male patient with a wound in the lower lip that was histologically diagnosed as an invasive squamous cell carcinoma. Mohs surgery was implemented and a transposition flap (Abbé flap) was used in the reconstruction of the upper lip. The complete opening of the mouth, without functional impairment of the speech or chewing function, and a favorable aesthetic result, were observed in the follow-up, thus demonstrating the usefulness of this type of reconstruction.

Keywords: MOHS SURGERY; CARCINOMA, SQUAMOUS CELL; RECONSTRUCTION

Basal cell carcinoma is the most common type of cancer and its non-surgical treatment has been the subject of many studies. Large lesions of this tumor are therapeutic challenges and the effective topical treatment has good applicability. The authors present a female patient diagnosed with multicentric superficial basal cell carcinoma in the lumbar region for more than 20 years, who refused to be treated surgically. The tumor reached dimensions of 12 cm x 10 cm. A decision was made for a non-surgical therapy, with the application of Imiquimod in a treatment of 5 weekly applications for 2 months. The treatment led to a clinical and histological cure, without recurrence to date (36 months), with excellent aesthetic results and few side effects.

Keywords: CARCINOMA, BASAL CELL; THERAPEUTICS; NEOPLASMS

The lips are a preferred site for carcinomas. Roughly 95% of tumors in the lips involve the lower lip, with 90% being squamous cell carcinomas. Surgery is the treatment of choice and has a good prognosis when diagnosis is performed early. Defects involving less than half of the lower lip can be closed using the edge-to-edge technique, whereas larger defects require greater technical complexity of methods and have increased risk of complications. The present article describes a straightforward technique for reconstructing these defects, using edge-to-edge suture, without necessity ofV or W shaped excisions, and with good aesthetic and functional outcomes.

Keywords: CARCINOMA, SQUAMOUS CELL; LIP NEOPLASMS; RECONSTRUCTIVE SURGICAL PROCEDURES

Lower lip squamous cell carcinomas (SCC) correspond to 20-30% of all oral cavity cancers. It mainly affects men over 50 years of age who have previous history of smoking, alcoholism and exposure to the sunlight. The diagnosis is clinical, confirmed by histological analysis. The present paper describes a case of a patient with a SCC affecting more than 1/3 of the lower lip, who underwent resection of the primary lesion and a conservative reconstruction of the lesion’s region, due to the great local mobility, aimed at preserving the functionality without compromising the aesthetic outcome.

Keywords: Carcinoma, squamous cell; Mouth neoplasms; Reconstruction

Cutaneous defects of the lower eyelid frequently require reconstructions with grafts or flaps to avoid ectropion. Removal of a basal cell carcinoma from the lower eyelid of a 39-year-old patient resulted in an exclusively cutaneous defect, with transversal and vertical diameters of 32 and 13mm, respectively. Despite the large size of the defect, the elevation of the suborbicularis oculi fascia to the periosteum of the lateral orbital border made primary closure possible. The position of the lower was also reinforced with a lateral canthopexy, with excellent aesthetic and functional results.

Keywords: Carcinoma, basal cell; Ectropion; Eyelids; Orbit; Reconstruction

The giant BCC is a rare variant, and the repair of large defects in the scalp, generated after oncologic resection, is a surgical challenge. We report the case of a patient submitted to late scalp reconstruction after oncologic resection of giant BCC in the scalp with the association of techniques. Reconstruction of scalp lesions depends on a comprehensive understanding of the anatomy of this site, knowledge of the arsenal of surgical techniques, and a detailed assessment of patient factors and expectations, given the impact on the quality of life and morbidity related to each therapeutic option.

Keywords: Carcinoma, Basal Cell; Reconstructive Surgical Procedures; Scalp Dermatoses

Basal cell carcinoma is the most common type of nonmelanoma skin cancer, and the nose is the most common site. The treatment of choice, surgical excision, may cause nasal defects, which may be challenging for surgeons for maintaining functionality and aesthetics. When planning the reconstruction, one should carefully consider the nose’s anatomical features and the patient’s individual characteristics. We report four cases of nasal defects due to surgical excision of basal cell carcinoma approached with different closure techniques (primary closure, flap, graft, and second-intention healing), achieving equally satisfactory esthetic and functional results..

Keywords: Carcinoma Basal Cell; Nose; Reconstruction; Surgical Flaps; Skin Transplantation

O queratoacantoma (QA), apesar de frequente na prática diária, é um tumor que gera questionamentos. O aspecto mais intrigante associa-se à sua posição no limite entre malignidade e benignidade. A abordagem do tumor, bem como sua classificação, é controversa. Na definição da conduta, é importante levar em conta o potencial de transformação para carcinoma espinocelular. Desse modo, a excisão cirúrgica é a terapia de escolha, sempre que possível. Algumas situações merecem atenção adicional, como a imunossupressão associada. Neste artigo, relatamos um caso de QA gigante em um paciente com síndrome da imunodeficiência adquirida tratado com cirurgia micrográfica de Mohs.

Keywords: Ceratoacantoma; Retalhos Cirúrgicos; Neoplasias Nasais; Neoplasias Cutâneas; Cirurgia de Mohs; Síndrome de Imunodeficiência Adquirida; HIV; Imunossupressão

Sarcomas são neoplasias mesenquimais malignas, raras, que acometem, principalmente, crianças e adolescentes. O rabdomiossarcoma, subtipo oriundo da musculatura esquelética, é condição incomum em adultos, acometendo sítios de localização não habitual, crescimento rápido e de difícil tratamento. Apresenta-se caso de adulto jovem com nodulação em lóbulo auricular esquerdo, cuja análise histopatológica e imuno-histoquímica confirmou tratar-se de rabdomiossarcoma alveolar, o qual foi conduzido em conjunto com a Oncologia.

Keywords: Rabdomiossarcoma Alveolar; Miogenina; Desmina; Excisão de Linfonodo

The cheek is the largest anatomical unit of the face. In this area, surgical skin cancer treatment must aim for its complete eradication and the best aesthetic-functional result. A 69-year-old woman presented with a 3.5 cm tumor in the left cheek for three years. Biopsy showed moderately differentiated squamous cell carcinoma. We performed an A-T flap, where the surgical defect corresponded to the “A” and the junction of the inferior orbital, nasofacial, and nasolabial grooves, to the top of the “T”. The patient evolved without recurrence and had an excellent aesthetic-functional aspect.

Keywords: Skin neoplasms; Carcinoma, Squamous cell; Zygoma; Surgical flaps; Reconstructive surgical procedures.