Histopathological Features of Basal Cell Carcinoma and Defect Reconstruction Using Rhomboid Flap: A Case Report

Authors

  • Molla Andriska Dewi Universitas Sumatera Utara
  • T. Ibnu Alferraly Universitas Sumatera Utara
  • Remenda Universitas Sumatera Utara

DOI:

https://doi.org/10.37287/ijghr.v7i6.389

Keywords:

basal cell carcinoma, case report, defect reconstruction, histopathology, rhomboid flap

Abstract

Basal cell carcinoma (BCC) is the most prevalent type of nonmelanoma skin cancer, primarily associated with chronic ultraviolet exposure and typically affecting elderly individuals. This case report aims to describe the clinicopathological features and management of BCC in an 81-year-old woman who presented with a hyperpigmented nodule on the left mandibular region. A comprehensive approach was undertaken, including clinical assessment, dermoscopic evaluation, and histopathological examination. The lesion was surgically excised, and the resulting defect was reconstructed using a rhomboid flap. This procedure achieved complete tumor clearance and successful defect closure, with favorable aesthetic and functional outcomes and no postoperative complications. This case highlights the effectiveness of rhomboid flap reconstruction in restoring tissue intergrity following BCC excision, emphasizes the improtance of early diagnosis and histopathology confirmation, and highlights the role of surgical technique in optimizing patient prognosis. Furthermore, the findings contribute to the body of evidence supporting the rhomboid flap as a reliable option for facial reconstruction following oncologic surgery, enhancing postoperati ve recovery and quality of life for patients undergoing facial oncologic surgery.

References

Bejinariu, C., Manescu, R., Boghian, L., Gheorghiu-Branaru, M., Popescu, S., & Marinescu, S. (2020). Scalp Reconstruction With Three Rhomboid Flaps After Squamous Cell Carcinoma Excision. Archives of the Balkan Medical Union, 55, 329–332. https://doi.org/10.31688/ABMU.2020.55.2.18

Cameron, M. C., Lee, E., Hibler, B. P., Barker, C. A., Mori, S., Cordova, M., Nehal, K. S., & Rossi, A. M. (2019). Basal cell carcinoma: Epidemiology; pathophysiology; clinical and histological subtypes; and disease associations. Journal of the American Academy of Dermatology, 80(2), 303–317. https://doi.org/10.1016/j.jaad.2018.03.060

De Vera, E., Magliano, J., & Bazzano, C. (2023). [Translated article] Large Cheek Defect Reconstruction With a Rhomboid Flap and Burow’s Advancement Flap After Excision of a Basal Cell Carcinoma. Actas Dermo-Sifiliográficas, 114(8), T722–T724. https://doi.org/10.1016/j.ad.2022.11.020

Demirseren, D. D., Ceran, C., Aksam, B., Demirseren, M. E., & Metin, A. (2014). Basal cell carcinoma of the head and neck region: a retrospective analysis of completely excised 331 cases. Journal of Skin Cancer, 2014, 858636. https://doi.org/10.1155/2014/858636

dos Santos, A. D., Haddad Filho, D., Nigro Marcelino, F. F., & Vieites, L. (2022). Applicability of the Limberg Flap: a case series. Surgical & Cosmetic Dermatology, 14. https://www.redalyc.org/articulo.oa?id=265570220016

Fania, L., Didona, D., Morese, R., Campana, I., Coco, V., Di Pietro, F. R., Ricci, F., Pallotta, S., Candi, E., Abeni, D., & Dellambra, E. (2020). Basal Cell Carcinoma: From Pathophysiology to Novel Therapeutic Approaches. Biomedicines, 8(11). https://doi.org/10.3390/biomedicines8110449

Haimovic, A., Sheehan, J. M., & Rohrer, T. E. (2019). Excisional Surgery and Repair, Flaps, and Grafts. In S. Kang, M. Amagai, A. L. Bruckner, A. H. Enk, D. J. Margolis, A. J. McMichael, & J. S. Orringer (Eds.), Fitzpatrick’s Dermatology, 9e. McGraw-Hill Education. http://accessmedicine.mhmedical.com/content.aspx?aid=1161346871

Ju, S., Fan, W., Rokohl, A. C., Guo, Y., Kakkassery, V., & Heindl, L. M. (2021). Genetic factors underlying basal cell carcinoma risk: a narrative review. Frontiers of Oral and Maxillofacial Medicine; Vol 5 (June 10, 2023): Frontiers of Oral and Maxillofacial Medicine. https://fomm.amegroups.org/article/view/57361

Kang, A. S., & Kang, K. S. (2020). Rhomboid Flap for Large Cutaneous Trunk Defect. Plastic and Reconstructive Surgery. Global Open, 8(6), e2932. https://doi.org/10.1097/GOX.0000000000002932

Kaya, G., Ataman, K., Güleşçi, S., & Yabaci Tak, A. (2025). Correlation of dermoscopic and histopathological features in basal cell carcinoma using computerized image analysis. Frontiers in Medicine, 12, 1581601. https://doi.org/10.3389/fmed.2025.1581601

Kim, G. K., Del Rosso, J. Q., & Bellew, S. (2009). Skin cancer in asians: part 1: nonmelanoma skin cancer. The Journal of Clinical and Aesthetic Dermatology, 2(8), 39–42.

Lewin, J. M., & Carucci, J. A. (2015). Advances in the management of basal cell carcinoma. F1000prime Reports, 7, 53. https://doi.org/10.12703/P7-53

Mackiewicz-Wysocka, M., Bowszyc-Dmochowska, M., Strzelecka-Węklar, D., Dańczak-Pazdrowska, A., & Adamski, Z. (2013). Basal cell carcinoma - diagnosis. Contemporary Oncology (Poznan, Poland), 17(4), 337–342. https://doi.org/10.5114/wo.2013.35684

Martens, M. C., Seebode, C., Lehmann, J., & Emmert, S. (2018). Photocarcinogenesis and Skin Cancer Prevention Strategies: An Update. Anticancer Research, 38(2), 1153–1158. https://doi.org/10.21873/anticanres.12334

Marzuka, A. G., & Book, S. E. (2015). Basal cell carcinoma: pathogenesis, epidemiology, clinical features, diagnosis, histopathology, and management. The Yale Journal of Biology and Medicine, 88(2), 167–179.

McDaniel, B., & Steele, R. B. (2025). Basal Cell Carcinoma. StatPearls [Internet]; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK482439/

Niculet, E., Craescu, M., Rebegea, L., Bobeica, C., Nastase, F., Lupasteanu, G., Stan, D. J., Chioncel, V., Anghel, L., Lungu, M., & Tatu, A. L. (2022). Basal cell carcinoma: Comprehensive clinical and histopathological aspects, novel imaging tools and therapeutic approaches (Review). Experimental and Therapeutic Medicine, 23(1), 60. https://doi.org/10.3892/etm.2021.10982

Panda, S. (2010). Nonmelanoma skin cancer in India: current scenario. Indian Journal of Dermatology, 55(4), 373–378. https://doi.org/10.4103/0019-5154.74551

Queirolo, P., Cinquini, M., Argenziano, G., Bassetto, F., Bossi, P., Boutros, A., Clemente, C., de Giorgi, V., Del Vecchio, M., Patuzzo, R., Peris, K., Quaglino, P., Reali, A., Zalaudek, I., & Spagnolo, F. (2023). Guidelines for the diagnosis and treatment of basal cell carcinoma: a GRADE approach for evidence evaluation and recommendations by the Italian Association of Medical Oncology. ESMO Open, 8(6), 102037. https://doi.org/10.1016/j.esmoop.2023.102037

Skoda, A. M., Simovic, D., Karin, V., Kardum, V., Vranic, S., & Serman, L. (2018). The role of the Hedgehog signaling pathway in cancer: A comprehensive review. Bosnian Journal of Basic Medical Sciences, 18(1), 8–20. https://doi.org/10.17305/bjbms.2018.2756

Tang, J. Y., Ervin H. Epstein, J., & Oro, A. E. (2019). Basal Cell Carcinoma and Basal Cell Nevus Syndrome. In S. Kang, M. Amagai, A. L. Bruckner, A. H. Enk, D. J. Margolis, A. J. McMichael, & J. S. Orringer (Eds.), Fitzpatrick’s Dermatology, 9e. McGraw-Hill Education. accessmedicine.mhmedical.com/content.aspx?aid=1161335298

Tasch, C., Pattiss, A., Lanthaler, M., & Pierer, G. (2022). A Modified Rhomboid Flap for Medial Canthal Reconstruction. Plastic and Reconstructive Surgery. Global Open, 10(1), e4074. https://doi.org/10.1097/GOX.0000000000004074

Teng, Y., Yu, Y., Li, S., Huang, Y., Xu, D., Tao, X., & Fan, Y. (2021). Ultraviolet Radiation and Basal Cell Carcinoma: An Environmental Perspective. Frontiers in Public Health, 9, 666528. https://doi.org/10.3389/fpubh.2021.666528

Wojtowicz, I., & Żychowska, M. (2025). Dermoscopy of Basal Cell Carcinoma Part 1: Dermoscopic Findings and Diagnostic Accuracy-A Systematic Literature Review. Cancers, 17(3). https://doi.org/10.3390/cancers17030493

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Published

2025-10-02

How to Cite

Dewi, M. A., Alferraly, T. I., & Siregar, R. (2025). Histopathological Features of Basal Cell Carcinoma and Defect Reconstruction Using Rhomboid Flap: A Case Report. Indonesian Journal of Global Health Research, 7(6), 341–350. https://doi.org/10.37287/ijghr.v7i6.389

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