Upper Eyelid Reconstruction Using Fricke Flap in a Rare Case of Basosquamous Cell Carcinoma

應用額顳皮瓣（Fricke皮瓣）於非全層上眼瞼缺陷之重建：一罕見上眼瞼基底鱗狀上皮細胞癌之病例報告

簡睿宏(Jui-Hung Chien) ； 戴念梓(Niann-Tzyy Dai) ； 陳拓安(To-An Chen) ； 陳天牧(Tim-Mo Chen) ； 王先震(Hsian-Jenn Wang)

《中華民國整形外科醫學會雜誌》 18卷1期 (2009/03) Pp. 50-59

https://doi.org/10.7096/JPSA.200903.0050

摘要

基底鱗狀上皮細胞癌是一種罕見的惡性腫瘤，它同時具有基底細胞癌和鱗狀上皮細胞癌的特徵，文獻報告其發生率約佔所有皮膚癌的1-2%。我們報告一位九十七歲的女性，因右上眼瞼罹患基底鱗狀上皮細胞癌，導致右眼無法張開而視線完全遮蔽。經廣泛性切除右上眼瞼惡性腫瘤及術中冷凍病理切片確認後，立即利用同側Fricke皮瓣施行重建手術，Fricke皮瓣是由單一主要血管（即淺顳動脈的額部分支）所供應的皮瓣，最早於西元1829年由Jochim Fricke所提出，對於眼眶周圍軟組織的重建很有利用價值，此皮瓣的供應區則由自體全層植皮覆蓋，而我們的病患於術後十二週追蹤時，對於重建後上眼瞼的功能及外觀感到滿意。

並列摘要

Basosquamous (cell) carcinoma is a rare malignancy consisting of the pathological features of both basal cell and squamous cell carcinomas. The reported incidence of basosquamous carcinoma is about 1-2% of all skin malignancies. Here we reported a 97-year-old female with a large size basosquamous cell carcinoma over right upper eyelid. The visual axis of right eye was occluded by the tumor. We performed a frozen section controlled excision of the whole layer of pretarsal tissue of upper eyelid with the immediate one-stage upper eyelid reconstruction by using the Fricke flap, a temporally based monopedicle forehead flap first described by Jochim Fricke in 1829. Autologous full-thickness skin graft was performed for coverage of the forehead defect of donor site. Effective coverage of lateral canthus and anterior lamella for upper eyelid reconstruction was achieved in this case by using the Fricke flap. Furthermore, the patient represented satisfied functional and cosmetic results at 12 weeks follow-up.

並列關鍵字

basosquamous cell carcinoma ； basal cell carcinoma ； squamous cell carcinoma ； upper eyelid reconstruction ； Fricke flap