Facial microcystic adnexal carcinoma-treatment with a “jigsaw puzzle” advancement flap and immediate esthetic reconstruction: A case report

摘要

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.