[Facial epitheliomas: general considerations, surgical techniques and indications]. 1998

D Martin, and I Barthélémy, and J M Mondie, and Y Grangier, and P Pélissier, and J P Loddé
Service de Chirurgie Plastique Reconstructrice et Esthétique, Centre Hospitalier Universitaire de Bordeaux, Hôpital du Tondu, France.

Carcinoma of the face is the skin disease most frequently encountered by plastic surgeons in everyday practice. Although basal cell carcinomas and squamous cell carcinomas are generally easy to recognize, their treatment remains subject to various schools of thought, or even individual practices, which are often difficult to define. This article defines a general plan of management of these tumours; their histological duality corresponds to a therapeutic duality. Resection of a basal cell carcinoma requires safety margins of 3 to 4 mm, versus at least 5 mm for a squamous cell carcinoma. In a high-risk subject, with a sclerodermiform carcinoma or undifferentiated squamous cell carcinoma, this safety margin may be as much as 10 mm or more. Frozen section examination is preferable in these situations. Six anatomical regions are studied selectively to define the main rules of reconstruction: nasal region, orbitopalpebral region, labial region, malar region, frontal region and auricular region. Each region will be subdivided into several subterritories, each requiring different strategies. The objectives, methods and indications of each reconstruction are selectively defined. The final strategy proposed is based not only on the author's personal experience, but also on the results of the national survey on carcinomas. As a complement to these therapeutic guidelines, the authors raise the problem of incomplete resection, which requires the definition of a peripheral infiltration index predictive of the recurrence rate. Surgery obviously cannot constitute exclusive treatment carcinomas, hence the value of presenting other methods currently available in the therapeutic armamentarium. Surveillance is essential in every case, determined by the patient's risk of recurrence or even metastatic dissemination.

UI MeSH Term Description Entries
D008048 Lip Neoplasms Tumors or cancer of the LIP. Cancer of Lip,Lip Cancer,Cancer of the Lip,Neoplasms, Lip,Cancer, Lip,Cancers, Lip,Lip Cancers,Lip Neoplasm,Neoplasm, Lip
D008297 Male Males
D009669 Nose Neoplasms Tumors or cancer of the NOSE. Cancer of Nose,Nasal Neoplasms,Nose Cancer,Cancer of the Nose,Nasal Cancer,Neoplasms, Nose,Cancer, Nasal,Cancer, Nose,Cancers, Nasal,Cancers, Nose,Nasal Cancers,Nasal Neoplasm,Neoplasm, Nasal,Neoplasm, Nose,Neoplasms, Nasal,Nose Cancers,Nose Neoplasm
D011182 Postoperative Care The period of care beginning when the patient is removed from surgery and aimed at meeting the patient's psychological and physical needs directly after surgery. (From Dictionary of Health Services Management, 2d ed) Care, Postoperative,Postoperative Procedures,Procedures, Postoperative,Postoperative Procedure,Procedure, Postoperative
D002280 Carcinoma, Basal Cell A malignant skin neoplasm that seldom metastasizes but has potentialities for local invasion and destruction. Clinically it is divided into types: nodular, cicatricial, morphaic, and erythematoid (pagetoid). They develop on hair-bearing skin, most commonly on sun-exposed areas. Approximately 85% are found on the head and neck area and the remaining 15% on the trunk and limbs. (From DeVita Jr et al., Cancer: Principles & Practice of Oncology, 3d ed, p1471) Carcinoma, Basal Cell, Pigmented,Epithelioma, Basal Cell,Rodent Ulcer,Ulcer, Rodent,Basal Cell Carcinoma,Basal Cell Carcinomas,Basal Cell Epithelioma,Basal Cell Epitheliomas,Carcinomas, Basal Cell,Epitheliomas, Basal Cell,Rodent Ulcers,Ulcers, Rodent
D002294 Carcinoma, Squamous Cell A carcinoma derived from stratified SQUAMOUS EPITHELIAL CELLS. It may also occur in sites where glandular or columnar epithelium is normally present. (From Stedman, 25th ed) Carcinoma, Epidermoid,Carcinoma, Planocellular,Carcinoma, Squamous,Squamous Cell Carcinoma,Carcinomas, Epidermoid,Carcinomas, Planocellular,Carcinomas, Squamous,Carcinomas, Squamous Cell,Epidermoid Carcinoma,Epidermoid Carcinomas,Planocellular Carcinoma,Planocellular Carcinomas,Squamous Carcinoma,Squamous Carcinomas,Squamous Cell Carcinomas
D002610 Cheek The part of the face that is below the eye and to the side of the nose and mouth. Bucca,Buccas,Cheeks
D003452 Cryosurgery The use of freezing as a special surgical technique to destroy or excise tissue. Cryoablation,Cryoablations,Cryosurgeries
D004428 Ear Neoplasms Tumors or cancer of any part of the hearing and equilibrium system of the body (the EXTERNAL EAR, the MIDDLE EAR, and the INNER EAR). Auricular Cancer,Auricular Neoplasms,Cancer of Ear,Ear Cancer,Cancer of Ear Auricle,Cancer of the Ear,Neoplasms of Ear Auricle,Neoplasms, Auricular,Neoplasms, Ear,Auricular Cancers,Cancer, Auricular,Cancers, Auricular,Ear Auricle Cancer,Ear Auricle Cancers,Ear Auricle Neoplasm,Ear Auricle Neoplasms,Ear Neoplasm,Neoplasm, Ear
D004431 Ear, External The outer part of the hearing system of the body. It includes the shell-like EAR AURICLE which collects sound, and the EXTERNAL EAR CANAL, the TYMPANIC MEMBRANE, and the EXTERNAL EAR CARTILAGES. External Ear,Outer Ear,Ear, Outer,Ears, External,Ears, Outer,External Ears,Outer Ears

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