Sacral Squamous Cell Carcinoma in Psoriatic Lesion:
Reconstruction by Combined Gluteal Turnover and
Fasciocutaneous Flap
Volume 2 - Issue 1
Naveen kumar* and Shobhit Gupta
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- Department of burns, Plastic and Maxillofacial Surgery, India
*Corresponding author:
DR. Naveen kumar, Department of Burns, Plastic and Maxillofacial Surgery, R.M.L Hospital and PGIMER,
New Delhi, India
Received: January 21, 2019; Published: January 28, 2019
DOI: 10.32474/SCSOAJ.2019.02.000126
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Abstract
Introduction: Studies have shown incidence of 1 – 5 % SCC development in old psoriatic plaques out of which sacrum is rare
site. In our case we excised a post psoriatic SCC and reconstructed it with a gluteus maximus turnover flap on one side along with
fasciocutaneous only VY advancement flap on other side.
Case Representation: A 45-year-old gentleman was presented with an ulceroproliferative growth on sacral region over the
pre-existing lesions of psoriasis for the last 6 months. The lesions were firm to hard in consistency, fixed to underlying fascia and
muscle, bone was free, there was sero-sanguineous oozing from the lesions. Histopathology was suggestive of well-differentiated
squamous cell carcinoma (SCC). Lesion was excised with 2 cm margin, in depth the level of excision was till periosteum of sacrum.
The true soft tissues defect was around 15 cm by 10 cm with exposed sacrum in the middle part. On right side gluteus maximum
muscle only turnover flap was raised, and on left side VY faciocutaneous flap was raised to cover the defect. Patient was discharged
on 10th Post-operative day.
Conclusion: We conclude that long standing psoriatic ulcer should always be assessed for conversion into malignancy. Gluteal
maximus muscle flaps can be used with various combinations with fasciocutaneous flaps for reconstruction of sacral defects.
Keywords: Psoriasis; sacral defects; squamous cell carcinoma; Gluteal maximus muscle flap
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