Reconstruction of Squamous Cell Carcinoma on Mouth Corner with Umbrella-Shaped Excision

초록

Purpose : The most common cancer of the lips is squamous cell carcinoma (SCC). And wide excision is the primary option of treatment. Since the mouth is a cosmetically and functionally mobile organ, careful reconstruction is required, especially for the mouth corner. We would like to share the case of successful reconstruction with a umbrella-shaped flap due to SCC on the right lip corner. Methods : A 69-year-old male patient was admitted for mass on right lip commissure. On the excisional biopsy, the mass was diagnosed with SCC. There was no significant finding in cervical lymph node on pre-operative MRI and no metastasis on PET-CT. We planned wide excision. And designed two semicircular shaped flap, looks like umbrella in parallel with the nasolabial fold to minimize disruption to the anatomical subunit. After wide excision, the defect was successfully covered as planned. Results : On the permanent biopsy, no cancer cells were found in the resection margin and the wound was totally healed without recurrence. Mild microstomia was occurred, but there were no significant problems with pronunciation or eating. After 13 months later, commissuroplasty was performed as the patient desired both cosmetic and functional enhancement especially for dental treatment. Conclusions : In lip cancer surgery, it is important not only to remove all cancer but also to preserve the function and appearance. We designed a umbrella-shaped excision to reconstruct of mouth corner defect and got successful reconstruction. Additionally, minimize postoperative compli cations such as microstomia and the patient showed great satisfaction in terms of the functional and cosmetic aspects