Repair of a Multisubunit Defect of the Earlobe, Preauricular Skin, and Superolateral Neck

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An 83-year-old woman was referred to the authors' department for the evaluation and management of a biopsy-proven 3.0 × 1.6-cm well-differentiated invasive squamous cell carcinoma of the left preauricular skin and earlobe. Histologically clear tumor-free margins were obtained after 3 stages using standard Mohs micrographic surgery technique, leaving a full-thickness, oval, obliquely oriented 5.5 × 2.4-cm defect of the preauricular skin, superolateral neck, and inferior and medial portions of the earlobe (Figure 1). Given the large diameter of the clinical tumor, anatomic location partially on the ear, and the large-caliber (defined as ≥0.1 mm in diameter) perineural invasion identified on the second Mohs stage, the patient would be a potential candidate for adjuvant radiation therapy (ART) after initial wound healing.
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