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. 2019:63:23-26.
doi: 10.1016/j.ijscr.2019.08.034. Epub 2019 Sep 11.

Versatility of the O-Z flap for back reconstruction after giant basal cell carcinoma resection: A case report and review of the literature

Matteo Torresetti  1 , Matteo Gioacchini  2 , Alessandro Scalise  2 , Giovanni Di Benedetto  2
Affiliations

Versatility of the O-Z flap for back reconstruction after giant basal cell carcinoma resection: A case report and review of the literature

Matteo Torresetti et al. Int J Surg Case Rep. 2019.

Abstract

Introduction: Giant basal cell carcinomas are rare and potentially aggressive skin malignancies that are infrequently reported in the Literature, and they usually require aggressive surgical resection and immediate soft tissue reconstruction with skin grafts or flaps. The large size of GBCCs has relevant implications not only for the metastatic potential, but even for the reconstructive challenging due to the possible limited availability of tissues for flap coverage.

Presentation of case: We report the peculiar case of an old patient who underwent to GBCC resection of the back measuring 16 × 13 cm, and immediate reconstruction with a large O to Z flap harvested from the back; one-year follow-up examination revealed a satisfactory result and no recurrence of the disease was observed.

Discussion: The review of the Literature showed that reconstructive options are mainly determined by the site and extent of the defect, exposed structures and patient characteristics and comorbidities, and previous series reported the use of skin grafts only, pedicled myocutaneous or perforator flaps, exclusively free flaps and a combination of techniques. Therefore, in this scenario local flaps such as O-Z flaps are less invasive procedures, that usually have lower rate of postoperative complications and shorter hospitalization compared to more complex procedures.

Conclusions: Despite the use of O-Z flap is quite unusual for back reconstruction, we believe that this flap represents a valid and safe alternative in selected cases, particularly in the elderly and medically compromised patients with multiple comorbidities.

Keywords: Back reconstruction; Flap; Giant basal cell carcinoma; O-Z flap.

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Conflict of interest statement

The authors declare that there is no conflict of interest.

Figures

Fig. 1
Fig. 1
Preoperative view of the giant basal cell carcinoma of the back measuring 16 × 13 cm.
Fig. 2
Fig. 2
Intraoperative figure showing the defect after tumor excision (A) and the sample sent to pathologist with flap markings (B).
Fig. 3
Fig. 3
Immediate postoperative result after the O-Z flap reconstruction (A) and the one-year follow-up picture showing no recurrences of the disease and an acceptable aesthetic result (B).
See this image and copyright information in PMC

References

    1. Archontaki M., Stavrianos S.D., Korkolis D.P., Arnogiannaki N., Vassiliadis V., Liapakis I.E., Christ H., Rapidis A.D., Kokkalis G. Giant basal cell carcinoma: clinicopathological analysis of 51 cases and review of the literature. Anticancer Res. 2009;29(July (7)):2655–2663. - PubMed
    1. Santos P.J., Prendergast C., Leis A. Giant anterior chest wall basal cell carcinoma: an approach to palliative reconstruction. Case Rep. Oncol. Med. 2016;2016 - PMC - PubMed
    1. Warbrick-Smith J., O’Neill J.K., Wilson P. Giant anterior chest wall basal cell carcinoma: a reconstructive challenge and review of the literature. BMJ Case Rep. 2013;2013(April) - PMC - PubMed
    1. Agha R.A., Borrelli M.R., Farwana R., Koshy K., Fowler A., Orgill D.P., For the SCARE group The SCARE 2018 statement: updating consensus surgical case report (SCARE) guidelines. Int. J. Surg. 2018;60:132–136. - PubMed
    1. de Bree E., Laliotis A., Manios A., Tsiftsis D.D., Melissas J. Super giant basal cell carcinoma of the abdominal wall: still possible in the 21st century. Int. J. Dermatol. 2010;49(July (7)):806–809. - PubMed