Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jan 26, 2021; 9(3): 607-613
Published online Jan 26, 2021. doi: 10.12998/wjcc.v9.i3.607
Facial microcystic adnexal carcinoma — treatment with a “jigsaw puzzle” advancement flap and immediate esthetic reconstruction: A case report
Yi-Ding Xiao, Ming-Zi Zhang, Ang Zeng
Yi-Ding Xiao, Ming-Zi Zhang, Ang Zeng, Department ofPlastic Surgery, Peking Union Medical College Hospital, Beijing 100730, China
Author contributions: Xiao YD and Zhang MZ contributed equally to this study; Xiao YD drafted the manuscript; Zhang MZ selected the figures and revised the manuscript; Zeng A was the patient’s doctor.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ang Zeng, MD, Adjunct Professor, Surgeon, Department of Plastic Surgery, Peking Union Medical College Hospital, No. 1 Shuaifu Yuan, Beijing 100730, China. zmzzxwk@126.com
Received: May 23, 2020
Peer-review started: May 23, 2020
First decision: November 26, 2020
Revised: November 30, 2020
Accepted: December 10, 2020
Article in press: December 10, 2020
Published online: January 26, 2021
Abstract
BACKGROUND

Microcystic adnexal carcinoma (MAC) is a rare malignant tumor of the skin that is commonly found on the face. It grows slowly and has a low mortality rate. However, for various reasons, including strong histological invasiveness, clinical inexperience and inadequate procedure design, immediate or permanent facial deformity may occur after surgical operations.

CASE SUMMARY

This article describes a middle-aged female artist who was diagnosed with MAC on the left upper lip. She declined the recommended treatment plan, which included two-stage reconstruction, skin grafting, or surgery that could have resulted in obvious facial dysfunction or esthetic deformity. We accurately designed a personalized procedure involving a “jigsaw puzzle advancement flap” for the patient based on the lesion location and the estimated area of skin loss. The procedure was successful; both pathological R0 resection and immediate and long-term esthetic reconstruction effects were achieved.

CONCLUSION

This study suggests that when treating facial MAC or other skin malignancies, a surgical team should have sufficient plastic surgery-related knowledge and skills. An optimal surgical plan for an individual is needed to achieve good facial esthetics and functional recovery and shorten the treatment course.

Keywords: Microcystic adnexal carcinoma, Esthetic reconstruction, Jigsaw puzzle advancement flap, Plastic surgery, Reconstruction, Esthetics, Case report

Core Tip: Microcystic adnexal carcinoma is a rare skin malignancy, which has a low mortality rate. In this study, we offered a new idea in treating a patient with microcystic adnexal carcinoma on the left upper lip and obtained satisfying esthetic reconstruction effect.