Giant basal cell carcinoma of the scalp: rotation advancement flap as successful dermatosurgical approach

Giant keratinocyte tumors, in particular basal cell carcinomas of the scalp area, are a serious challenge for dermatosurgeons, oncologists, maxillofacial and reconstructive surgeons. The area is limited terms skin mobility, its elasticity decreases with age. size tumors this degree infiltration underlying tissues important therapeutic choice - from surgical removal, waiting granulationsto form placing split mesh graft (at later stage), to performing complex rotational/transpositional or progressive flaps. Achieving an optimal aesthetic result often interventions carried out based on decisions multidisciplinary teams. Alternatives such as radiotherapy targeted therapy vismodegib, example, could be administered both preoperatively postoperatively first-line depending tumor board decisions. We present 69-year-old female patient histopathologically proven preoperative giant carcinoma that did not involve tabula externa. Surgical treatment under general anesthesia was planned. A ultrasound performed due repositioned preservation feeding arteries. During operation, resection lines were close proximity, but affect arterial vessels. After applying rotational advancement flap technique, anesthesia, cosmetic effect achieved.