Successful Reconstruction After Resection of Malignant Eccrine Poroma Using Retroauricular Artery Perforator-Based Island Flap

Abstract

Introduction: Malignant eccrine poroma (MEP), or porocarcinoma, is a rare malignant tumor arising from the intraepidermal eccrine duct. It has propensity to arise on the lower limbs (44%), trunk (24%), or head and neck region (24%) but rarely occurs on the scalp. It is very difficult to find proper technique for the first time. In this paper, we introduce rare MEP developing in a longstanding eccrine poroma on the scalp (postauricular area) and successful reconstruction method using perforator-based island flap. Patient and Methods: A 52-year-old man who had an abrupt growth of a mass on the temporal area presented to us. It was a 3.7 x 2.1-cm mass with fungated margin, but it does not involve the perivertebral muscle and fat tissues in computed tomography scan. The next we executed was general operation for wide excision and scalp reconstruction of a large postauricular defect using retroauricular artery perforator-based island flap. Result: We harvested 7 x 5 cm sized flap and donor site closed primarily without any skin graft. We found that the flap had mild congestion after the suture and mild fullness because of swelling. Conclusions: Retroauricular artery perforator-based island flap can survive over the bone, protect the infection, and bear the radiological treatment. Aesthetically, the patient was very satisfied with the result: similar skin texture, color, thickness, and pliability. There was only a linear scar on the lower margin of the mandible.