Lower leg reconstruction after resection of a squamous cell carcinoma on necrobiosis lipoidica with a pedicled fibula and an extended anterolateral thigh flap—a case report
Abstract Background Extensive loss of soft tissue and bone due to neoplasia, trauma, or infection in extremities often leads to amputation. Case presentation We present the case of a 72-year-old female patient presenting with an extended cutaneous squamous cell carcinoma of the lower leg, developed...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-02-01
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| Series: | World Journal of Surgical Oncology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12957-023-02923-z |
| _version_ | 1828035174365921280 |
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| author | Olimpiu Bota Friedegund Meier Marlene Garzarolli Klaus-Dieter Schaser Adrian Dragu Feras Taqatqeh Hagen Fritzsche |
| author_facet | Olimpiu Bota Friedegund Meier Marlene Garzarolli Klaus-Dieter Schaser Adrian Dragu Feras Taqatqeh Hagen Fritzsche |
| author_sort | Olimpiu Bota |
| collection | DOAJ |
| description | Abstract Background Extensive loss of soft tissue and bone due to neoplasia, trauma, or infection in extremities often leads to amputation. Case presentation We present the case of a 72-year-old female patient presenting with an extended cutaneous squamous cell carcinoma of the lower leg, developed on top of necrobiosis lipoidica. After achieving the R0 resection, a 26 × 20-cm soft tissue and 15-cm tibial bone defect resulted. The contralateral leg had been lost due to the same disease 18 years before. We achieved a successful reconstruction of the leg using a pedicled fibula transplantation, an extended anterolateral thigh perforator flap, and an internal fixation with plate and screws. Two years after the original surgery, the patient is relapse-free and mobile, with adequate function of the reconstructed foot. Conclusions Our case presented a unique combination of pedicled fibula transplantation and free extended ALT perforator flap to reconstruct an extensive defect after resection of a rare cSCC on top of NL. In selected cases, the boundaries of limb salvage can be pushed far beyond the current standards of treatment. |
| first_indexed | 2024-04-10T15:44:06Z |
| format | Article |
| id | doaj.art-481ffa76138946f39ca54a9039e94c1b |
| institution | Directory Open Access Journal |
| issn | 1477-7819 |
| language | English |
| last_indexed | 2024-04-10T15:44:06Z |
| publishDate | 2023-02-01 |
| publisher | BMC |
| record_format | Article |
| series | World Journal of Surgical Oncology |
| spelling | doaj.art-481ffa76138946f39ca54a9039e94c1b2023-02-12T12:13:55ZengBMCWorld Journal of Surgical Oncology1477-78192023-02-012111710.1186/s12957-023-02923-zLower leg reconstruction after resection of a squamous cell carcinoma on necrobiosis lipoidica with a pedicled fibula and an extended anterolateral thigh flap—a case reportOlimpiu Bota0Friedegund Meier1Marlene Garzarolli2Klaus-Dieter Schaser3Adrian Dragu4Feras Taqatqeh5Hagen Fritzsche6University Center for Orthopedics, Trauma and Plastic Surgery, Faculty of Medicine Carl Gustav Carus, TU DresdenDepartment of Dermatology, Faculty of Medicine Carl Gustav Carus, TU DresdenDepartment of Dermatology, Faculty of Medicine Carl Gustav Carus, TU DresdenUniversity Center for Orthopedics, Trauma and Plastic Surgery, Faculty of Medicine Carl Gustav Carus, TU DresdenUniversity Center for Orthopedics, Trauma and Plastic Surgery, Faculty of Medicine Carl Gustav Carus, TU DresdenUniversity Center for Orthopedics, Trauma and Plastic Surgery, Faculty of Medicine Carl Gustav Carus, TU DresdenUniversity Center for Orthopedics, Trauma and Plastic Surgery, Faculty of Medicine Carl Gustav Carus, TU DresdenAbstract Background Extensive loss of soft tissue and bone due to neoplasia, trauma, or infection in extremities often leads to amputation. Case presentation We present the case of a 72-year-old female patient presenting with an extended cutaneous squamous cell carcinoma of the lower leg, developed on top of necrobiosis lipoidica. After achieving the R0 resection, a 26 × 20-cm soft tissue and 15-cm tibial bone defect resulted. The contralateral leg had been lost due to the same disease 18 years before. We achieved a successful reconstruction of the leg using a pedicled fibula transplantation, an extended anterolateral thigh perforator flap, and an internal fixation with plate and screws. Two years after the original surgery, the patient is relapse-free and mobile, with adequate function of the reconstructed foot. Conclusions Our case presented a unique combination of pedicled fibula transplantation and free extended ALT perforator flap to reconstruct an extensive defect after resection of a rare cSCC on top of NL. In selected cases, the boundaries of limb salvage can be pushed far beyond the current standards of treatment.https://doi.org/10.1186/s12957-023-02923-zExtended cutaneous scquamous cell carcinomaNecrobiosis lipoidicaPedicled fibula transplantationAnterolateral thigh perforator flapReconstructive microsurgerySurgical oncology |
| spellingShingle | Olimpiu Bota Friedegund Meier Marlene Garzarolli Klaus-Dieter Schaser Adrian Dragu Feras Taqatqeh Hagen Fritzsche Lower leg reconstruction after resection of a squamous cell carcinoma on necrobiosis lipoidica with a pedicled fibula and an extended anterolateral thigh flap—a case report World Journal of Surgical Oncology Extended cutaneous scquamous cell carcinoma Necrobiosis lipoidica Pedicled fibula transplantation Anterolateral thigh perforator flap Reconstructive microsurgery Surgical oncology |
| title | Lower leg reconstruction after resection of a squamous cell carcinoma on necrobiosis lipoidica with a pedicled fibula and an extended anterolateral thigh flap—a case report |
| title_full | Lower leg reconstruction after resection of a squamous cell carcinoma on necrobiosis lipoidica with a pedicled fibula and an extended anterolateral thigh flap—a case report |
| title_fullStr | Lower leg reconstruction after resection of a squamous cell carcinoma on necrobiosis lipoidica with a pedicled fibula and an extended anterolateral thigh flap—a case report |
| title_full_unstemmed | Lower leg reconstruction after resection of a squamous cell carcinoma on necrobiosis lipoidica with a pedicled fibula and an extended anterolateral thigh flap—a case report |
| title_short | Lower leg reconstruction after resection of a squamous cell carcinoma on necrobiosis lipoidica with a pedicled fibula and an extended anterolateral thigh flap—a case report |
| title_sort | lower leg reconstruction after resection of a squamous cell carcinoma on necrobiosis lipoidica with a pedicled fibula and an extended anterolateral thigh flap a case report |
| topic | Extended cutaneous scquamous cell carcinoma Necrobiosis lipoidica Pedicled fibula transplantation Anterolateral thigh perforator flap Reconstructive microsurgery Surgical oncology |
| url | https://doi.org/10.1186/s12957-023-02923-z |
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