Upper Eyelid Reconstruction Using Fricke Flap in a Rare Case of Basosquamous Cell Carcinoma

Basosquamous (cell) carcinoma is a rare malignancy consisting of the pathological features of both basal cell and squamous cell carcinomas. The reported incidence of basosquamous carcinoma is about 1-2% of all skin malignancies. Here we reported a 97-year-old female with a large size basosquamous cell carcinoma over right upper eyelid. The visual axis of right eye was occluded by the tumor. We performed a frozen section controlled excision of the whole layer of pretarsal tissue of upper eyelid with the immediate one-stage upper eyelid reconstruction by using the Fricke flap, a temporally based monopedicle forehead flap first described by Jochim Fricke in 1829. Autologous full-thickness skin graft was performed for coverage of the forehead defect of donor site. Effective coverage of lateral canthus and anterior lamella for upper eyelid reconstruction was achieved in this case by using the Fricke flap. Furthermore, the patient represented satisfied functional and cosmetic results at 12 weeks follow-up.