Reconstruction of Scalp Basal Cell Carcinoma Using Pinwheel Flap: A Case Report

Abstract

Ideal reconstruction of the scalp should ensure adequate coverage and protection of the underlying areas of the reconstruction site, include an adequate volume of soft and hard tissue, and contour the reconstruction of the area to accelerate wound healing, acceptable beauty, and proper function and reduce complications after the operation. This study aimed to present our experience regarding basal cell carcinoma (BCC) in the scalp and show the reconstructive option for BCC cancer in the scalp. A 69-year-old man was admitted due to the recurrence of the lesions in the forehead and scalp area, and he underwent surgery again one year ago. On initial examination, a lesion sized 5 cm× 5cm with an indistinct margin was visible in the frontal region. The lesion had bleeding, itching, and purulent discharge. Computed tomography scan results indicated skull bone resorption, and pathologic report showed active ulcer BCC with infiltrative growth pattern widely disseminated in deep portion. Tumor size was 4.5 cm × 4.3 cm × 1.5 cm and was negative for lymphovascular invasion. The patient was organized for wide local excision of the lesion. Following the tumor resection, the remaining oval defect was reconstructed using the pinwheel flap under general anesthesia in the operating room. It seems that the pinwheel flap design is an effective approach for the reconstruction of extensive lesions of the scalp.

Keywords: Basal cell carcinoma, Pinwheel flap, Reconstruction, Scalp lesion