1/29. Two modifications of the radial forearm flap for reconstruction of complex facial defects.The free radial forearm flap has been one of the most common free flaps of recent decades. This flap is employed predominantly in head and neck reconstruction. The possibility of combining bone, muscle, and nerves with the fasciocutaneous flap greatly enhanced reconstructive options. However, the frequently unsightly donor site and the development of other readily available free flaps have led to a decline in the use of the radial forearm flap. Nevertheless, for reconstruction in head and neck surgery, with the need for thin, pliable tissues and a long vascular pedicle, the radial forearm flap still remains a prime choice. Two modifications of the standard forearm flap are presented. The first patient had two large defects at the nose and mental area after radical resection of a basal-cell carcinoma. Soft-tissue reconstruction was achieved with a conventional forearm flap and a second additional skin island based on a perforator vessel originating proximally from the pedicle. Both skin islands were independently mobile and could be sutured tension-free into the defects after tunneling through the cheek, with vascular anastomosis to the facial vessels. The second patient required additional volume to fill the orbital cavity after enucleation of the eye due to an ulcerating basal-cell carcinoma. In this case, the body of the flexor carpi radialis muscle was included in the skin flap to fill the defect. The skin island was used to reconstruct the major soft-tissue defect.- - - - - - - - - - ranking = 1keywords = island (Clic here for more details about this article) |
2/29. Metastatic basal cell carcinoma of the axilla: report of a case and reconstruction with an island lateral pectoral flap.A case of metastatic basal cell carcinoma arising from the skin of the axilla is reported. Multiple surgical procedures performed previously for recurrences of basal cell carcinoma limited the availability of conventional local flaps in the reconstruction of the axillary defect after excision of the recurrent tumor and axillary nodal dissection. The use of an island flap based on the lateral pectoral vessels and lateral cutaneous branches of the intercostal vessels is described.- - - - - - - - - - ranking = 1.6666666666667keywords = island (Clic here for more details about this article) |
3/29. The full-thickness retroangular flap.In reconstruction of full-thickness nasal defects, excellent outcome from both the cosmetic and functional viewpoints is desired, and minimal scar in the flap donor site is favored. The authors describe a new reconstructive method in which full-thickness nasal defects are repaired with a full-thickness island flap collected from the nasolabial region, with the retrograde angular artery as the pedicle. The authors call this flap the full-thickness retroangular flap, and used it to repair full-thickness nasal defects generated by resection of cutaneous malignant tumors in 2 patients. The advantages of this method were the following: reconstruction of the external side of the nose and lining of the nasal cavity could be performed with one flap; the color and texture of the reconstructed nose were favorable; being an arterial flap, good blood circulation was obtained; and closing of the flap donor site was easy.- - - - - - - - - - ranking = 0.33333333333333keywords = island (Clic here for more details about this article) |
4/29. Pedicled scrotal island skin flap in the treatment of anal basal cell carcinoma.Basal cell carcinoma of the anus is extremely rare, accounting for only 0.1% of anorectal malignancies. We report the reconstruction of the anus with a biaxial pedicled scrotal island myofasciocutaneous flap following excision of an anal basal cell carcinoma, and conclude that this technique may be valuable in the reconstruction of the anal region.- - - - - - - - - - ranking = 1.6666666666667keywords = island (Clic here for more details about this article) |
5/29. Cutaneous lymphadenoma.Lymphoepithelial neoplasms are biphasic tumours that contain both epithelial and lymphoid components. This heterogeneous group includes benign cutaneous lymphadenoma (CL), malignant lymphoepithelioma-like carcinoma of the skin and dermal thymus. We present two cases of CL in male subjects of 14 and 64 years of age. The latter man had a history of multiple basal cell carcinomas (BCCs) and solar keratoses. Histological sections of both tumours revealed similar features of an invasive non-ulcerated tumour with a mixed architecture of BCC and trichoepithelioma. Immunocytochemical examination revealed a biphasic epithelial tumour of follicular differentiation, possibly a variant of trichoepithelioma or a BCC. Within the epithelial islands there was a heavy infiltration that was confirmed as CD3-positive T cells and S-100-positive dendritic cells by immunocytochemistry.- - - - - - - - - - ranking = 0.33333333333333keywords = island (Clic here for more details about this article) |
6/29. melanoma or pigmented basal cell carcinoma: a clinical-pathologic correlation with dermoscopy, in vivo confocal scanning laser microscopy, and routine histology.BACKGROUND/PURPOSE: New techniques are being explored for improving diagnostic accuracy of pigmented skin lesions. Confocal scanning laser microscopy (CSLM) may represent such a novel technique. The purpose of this report was to demonstrate the potential application of CSLM as an aid in the diagnosis of a pigmented skin lesion that is clinically suspicious for melanoma. methods: An irregular pigmented lesion was examined clinically and dermoscopically. The lesion was imaged by CSLM and subsequently excised for histologic examination. Findings from CSLM were correlated with features observed on the dermoscopic and histologic examination. RESULTS: Confocal scanning laser microscopy (CSLM) allowed for the non-invasive visualization of the histologic features of superficial pigmented BCC, including buds and "islands" of tumor cells at the dermoepidermal junction and melanin-laden macrophages. Conventional histology confirmed the diagnosis of pigmented BCC. CONCLUSION: Confocal scanning laser microscopy (CSLM) may serve as an aid in the non-invasive diagnosis of pigmented skin lesions clinically suspicious for melanoma.- - - - - - - - - - ranking = 0.33333333333333keywords = island (Clic here for more details about this article) |
7/29. Hemiphiltrum rotated flap.In three patients of different ages, large resections of the philtrum have been repaired by rotating island flaps from the residual philtrum, leaving inconspicuous scars and no contour deformity. The rotated hemiphiltrum flap described here is an easy and safe procedure performed with local anesthesia that may be an effective cosmetic and functional repair of selected difficult surgical defects of the central upper lip involving the philtrum.- - - - - - - - - - ranking = 0.33333333333333keywords = island (Clic here for more details about this article) |
8/29. Basal cell carcinoma with matrical differentiation.Basal cell carcinoma (BCC) may exhibit diverse differentiation. In BCC with matrical differentiation, islands of shadow cells, which are characteristic of a pilomatricoma, are located within the tumor. This is an extremely rare variant and to our knowledge, only two review articles and one case report have been published. We recently experienced a case of BCC with matrical differentiation in a 45-year-old Caucasian male. This tumor should be differentially diagnosed from other tumors, particularly a pilomatricoma and pilomatrix carcinoma.- - - - - - - - - - ranking = 0.33333333333333keywords = island (Clic here for more details about this article) |
9/29. Aggressive tumors of the concha: treatment with postauricular island pedicle flap.BACKGROUND: The concha is a partially hidden anatomical area characterized by difficult access and reconstruction. OBJECTIVE: We describe the use of the postauricular (revolving door) island pedicle flap in the treatment of aggressive tumors of the concha. methods: We present two patients with aggressive cutaneous tumors localized in auricular concha. One of the patients presented with a large ulcerated basal cell carcinoma. The second patient had received a heart transplant, was receiving immunosuppressive therapy, and was affected by a squamous cell carcinoma. RESULTS: Both defects were closed using a posterior auricular island flap that was advanced through cartilage with excellent cosmetic results. CONCLUSION: The postauricular island pedicle flap is well suited for conchal reconstruction because of its proximity to the defect. The flap was transferred from posterior to anterior toward the concha, followed by primary closure of the retroauricular donor site.- - - - - - - - - - ranking = 2.3333333333333keywords = island (Clic here for more details about this article) |
10/29. Basal cell carcinoma with matrical differentiation.Three cases of basal cell carcinoma showing shadow cells within basaloid islands have been described using the term basal cell carcinoma with matrical differentiation for this histologic variant. We present four new cases of basal cell carcinoma with evidence of matrical differentiation. Unlike the cases previously published, these lesions showed nests of shadow cells either within the lobules of basaloid cells or forming nests in the stroma. We also noted the presence of a foreign body reaction and calcification. These neoplasms illustrate the capability of basal cell carcinoma to differentiate toward hair matrix cells. Basal cell carcinoma with matrical differentiation must be added to the uncommon variants of basal cell carcinoma showing adnexal differentiation. A parallel between the degrees of differentiation of the cutaneous sebaceous neoplasms with those showing matrical differentiation is proposed.- - - - - - - - - - ranking = 0.33333333333333keywords = island (Clic here for more details about this article) |
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