Pericranial periosteal flap for upper eyelid reconstruction post Merkel Cell Carcinoma Excision
Author: Haider Zaki
Base Hospital / Institution: Royal Hallamshire Hospital
ePoster presentation
Abstract ID: 25-199
Purpose
To report a case of full upper eyelid reconstruction using a pericranial periosteal flap technique and full thickness skin graft post excision of a Merkel Cell Carcinoma
Methods
Review of patient’s notes including clinical examination, histopathology findings, external photographs, CT / MRI / PET scans and management.
Results
A 79 years old female presented to her GP and the local district hospital with a rapidly growing lesion in right upper eyelid that was treated as a stye with no response. She had a rapidly growing violaceous nodule involving 80% of right upper lid anterior and posterior lamellae. Patient had a punch biopsy that confirmed a Merkel Cell Carcinoma. She underwent staged excision of the lesion that required further excision at second stage and subsequent reconstruction using pericranial periosteal flap and full thickness skin graft. This was complicated with limited area of graft necrosis that settled later without any further intervention. CT and PET scans revealed a solitary lung nodule that was biopsied and showed an indolent B cell lymphoma and not a metastatic lesion.
Conclusion
Merkel Cell Carcinoma is an aggressive, high grade cutaneous neuroendocrine tumor that can involve the entire eyelid within few days to weeks. Pericranial perisoteal flap is an excellent technique to provide reconstruction of entire length of upper eyelid posterior lamella. Incision in forehead can be placed in frown lines and achieve good cosmetic outcome. Despite the recognised limitation of low blood flow in periosteum making it a relatively poor host for a skin graft, patient did well . Using a skin flap rather than a graft to reconstruct anterior lamella can be considered in these cases.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Samantha | Hunt | Royal Hallamshire Hospital |
