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Review
. 2015 Jun 24:15:e26.
eCollection 2015.

Reconstruction With Pedicled Anterolateral Thigh Flap After Wide Local Excision of Penoscrotal Extramammary Paget's Disease: A Case Report and Comprehensive Literature Review

Cedric L Hunter  1 , Eila C Skinner  2 , Gordon K Lee  1
Affiliations
Review

Reconstruction With Pedicled Anterolateral Thigh Flap After Wide Local Excision of Penoscrotal Extramammary Paget's Disease: A Case Report and Comprehensive Literature Review

Cedric L Hunter et al. Eplasty. .

Abstract

Objective: The clinical characteristics, management, and prognostic indicators of penoscrotal extramammary Paget's disease are not clearly defined. Surgical excision is often an effective treatment modality but results in a large wound after resection of all involved tissues.

Methods: Reconstruction of large penoscrotal soft-tissue defects after wide local excision remains a challenge to the reconstructive surgeon. The use of the anterolateral thigh flap for penoscrotal reconstruction after resection of extramammary Paget's disease is infrequent as a reconstruction tool throughout the literature.

Results: We discuss a case where the anterolateral thigh flap was effectively used for reconstruction of a large penoscrotal defect after wide local excision of penoscrotal extramammary Paget's disease and present a comprehensive literature review of extramammary Paget's disease key features, diagnosis, prognosis, and treatment.

Conclusions: The anterolateral thigh flap is a useful tool for penoscrotal defect reconstruction.

Keywords: anterolateral thigh flap; extramammary Paget’s disease; penoscrotal reconstruction; wide local excision.

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Figures

Figure 1
Figure 1
ALT flap used for reconstruction after wide local excision of EMPD. (Top, left and right) Penoscrotal EMPD before WLE with 3-cm surgical margin. (Below, left) Markings for right thigh ALT flap with marked perforators. (Bottom, center) Wound after resection of EMPD lesion full thickness down to fascia. (Bottom, right) Reconstruction of soft-tissue defect with the pedicle ALT flap after standard elevation and tunneling beneath the rectus femoris and sartorius muscles.
Figure 2
Figure 2
Healed ALT flap after surgery. (Top) ALT flap reconstruction of penoscrotal defect with good coverage, no contracture, and good functional result. (Bottom) Well-healed donor site with good thigh strength and no loss of sensation.
See this image and copyright information in PMC

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References

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