Published online Jan 26, 2021. doi: 10.12998/wjcc.v9.i3.607
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
Processing time: 242 Days and 6.5 Hours
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.
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.
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.
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.