Single-stage defect repair with latissimus dorsi free flap after extensiveresection of terebrant ulcer of the head: Three case reports

Three cases of advanced ulcerating basal cell carcinoma (terebrant ulcer or ulcus terebrans) of the head are reported. Neglected basaliomas had deeply destroyed larger parts of the skull in three women ages 78, 69, and 65 yea rs when the patients were first admitted for treatment. Death due to mening itis, hemorrhage, or brain damage was imminent. Wide resection and coverage by free latissimus dorsi flaps was carried out in single-stage procedures. The latissimus dorsi, a versatile and very reliable free flap with its con stant vascular anatomy and long pedicle, is the ideal flap for the coverage of large defects on the head. The donor site can usually be closed primari ly, and the functional deficit is acceptable. All three patients recovered completely. Although only palliative resection could be achieved, the proce dures could be justified by the increased survival time and gain in quality of life. (C) 2001 Wiley-Liss, Inc.