{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T03:00:44Z","timestamp":1781665244255,"version":"3.54.5"},"reference-count":11,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,1,29]],"date-time":"2025-01-29T00:00:00Z","timestamp":1738108800000},"content-version":"vor","delay-in-days":28,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Reports"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Basocellular carcinoma (BCC) is the most prevalent skin malignancy, often localizing to the UV\u2010exposed skin of the face. While most BCC is relatively indolent, aggressive subtypes, including infiltrative BCC, pose the treatment challenges of ensuring functional and aesthetic preservation with a high risk of recurrence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case<\/jats:title><jats:p>A 78\u2010year\u2010old female patient complained of recurrent left chin BCC of infiltrative subtype, which was first treated in 2013 by wide local excision and adjuvant radiotherapy. Recurrent carcinoma was reported in 2017, 2021, and most recently in 2023. The most recent recurrence presented with scar contracture, facial asymmetry, and drooping of the lip. Surgical resection involved extensive excision of the lower lip and chin, exposing the mandible. Reconstruction was achieved with the help of bilaterally designed Karapandzic flaps for the lip and a bilobed rotational flap for the chin defect. Although no chemotherapy and immunotherapy were given, the functional and aesthetic result were satisfactory. The procedure was executed while preserving the pertinent neurovascular structures, maintaining oral competence, and restoring the lower face. The Karapandzic flap was helpful in maintaining the lip function, whereas the chin was reconstructed using the bilobed rotational flap. Post\u2010operative histology confirmed the diagnosis of BCC with squamous differentiation, which had clear margins. The patient did well and the cosmetic and functional outcome was satisfactory without any disease at 18\u2009months after surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This case sheds light on the difficulties encountered in treating recurrent facial BCC in developing countries. In the absence of systemic therapies, advanced surgical techniques and intensive follow\u2010up resulted in a long disease\u2010free period with good functional and aesthetic outcomes, thanks to the successful use of innovative reconstruction even in a low\u2010resource setting.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cnr2.70124","type":"journal-article","created":{"date-parts":[[2025,1,30]],"date-time":"2025-01-30T03:24:51Z","timestamp":1738207491000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Case Report: The Versatile Art of Reconstruction: A Decade\u2010Long Journey With Recurrent Facial Basal Cell Carcinoma"],"prefix":"10.1002","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2906-0002","authenticated-orcid":false,"given":"T. H.","family":"Pathirana","sequence":"first","affiliation":[{"name":"Surgical Oncology Unit Teaching Hospital Anuradhapura  Anuradhapura Sri Lanka"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V.","family":"Bandaranayake","sequence":"additional","affiliation":[{"name":"Surgical Oncology Unit Teaching Hospital Anuradhapura  Anuradhapura Sri Lanka"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. P.","family":"Nellihela","sequence":"additional","affiliation":[{"name":"Surgical Oncology Unit Teaching Hospital Anuradhapura  Anuradhapura Sri Lanka"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Nikeshala","sequence":"additional","affiliation":[{"name":"Surgical Oncology Unit Teaching Hospital Anuradhapura  Anuradhapura Sri Lanka"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"Saranga","sequence":"additional","affiliation":[{"name":"Surgical Oncology Unit Teaching Hospital Anuradhapura  Anuradhapura Sri Lanka"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Abegunasekara","sequence":"additional","affiliation":[{"name":"Surgical Oncology Unit Teaching Hospital Anuradhapura  Anuradhapura Sri Lanka"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Gunathilake","sequence":"additional","affiliation":[{"name":"Surgical Oncology Unit Teaching Hospital Anuradhapura  Anuradhapura Sri Lanka"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N. J.","family":"Asanthi","sequence":"additional","affiliation":[{"name":"Histopathology Department Teaching Hospital Anuradhapura  Anuradhapura Sri Lanka"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,1,29]]},"reference":[{"issue":"1","key":"e_1_2_9_2_1","first-page":"30","article-title":"Management of Basal Cell Carcinoma: Evidence\u2010Based Guidelines","volume":"80","author":"Cameron R. L.","year":"2019","journal-title":"Journal of the American Academy of Dermatology"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.2012.10830.x"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0000000000009959"},{"key":"e_1_2_9_5_1","unstructured":"National Comprehensive Cancer Network (NCCN) \u201cGuidelines for Nonmelanoma Skin Cancer \u201dNCCN Guidelines (2023) https:\/\/www.nccn.org."},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2017.10.006"},{"issue":"3","key":"e_1_2_9_7_1","first-page":"525","article-title":"Advanced Reconstructive Techniques in the Management of Facial Basal Cell Carcinoma","volume":"124","author":"Iorio M. L.","year":"2021","journal-title":"Journal of Surgical Oncology"},{"issue":"2","key":"e_1_2_9_8_1","first-page":"345","article-title":"Reconstruction of Complex Facial Defects After Basal Cell Carcinoma Excision Using the Karapandzic Flap","volume":"149","author":"McKee D. M.","year":"2022","journal-title":"Journal of Plastic and Reconstructive Surgery"},{"issue":"6","key":"e_1_2_9_9_1","first-page":"527","article-title":"The Karapandzic Flap","volume":"53","author":"Karapandzic M.","year":"1974","journal-title":"Plastic and Reconstructive Surgery"},{"issue":"2","key":"e_1_2_9_10_1","first-page":"271","article-title":"Guidelines of Care for the Management of Basal Cell Carcinoma","volume":"74","author":"Bichakjian C. K.","year":"2016","journal-title":"Journal of the American Academy of Dermatology"},{"issue":"1","key":"e_1_2_9_11_1","first-page":"7","article-title":"The Evolving Role of Systemic Therapies in the Treatment of Advanced Basal Cell Carcinoma","volume":"47","author":"Lear J. T.","year":"2022","journal-title":"Clinical and Experimental Dermatology"},{"issue":"6","key":"e_1_2_9_12_1","first-page":"612","article-title":"Advanced Surgical Techniques in the Management of Recurrent Facial Basal Cell Carcinoma","volume":"47","author":"Patel N. A.","year":"2021","journal-title":"Journal of Dermatologic Surgery"}],"container-title":["Cancer Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cnr2.70124","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,30]],"date-time":"2025-01-30T15:54:31Z","timestamp":1738252471000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/cnr2.70124"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1]]},"references-count":11,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,1]]}},"alternative-id":["10.1002\/cnr2.70124"],"URL":"https:\/\/doi.org\/10.1002\/cnr2.70124","archive":["Portico"],"relation":{},"ISSN":["2573-8348","2573-8348"],"issn-type":[{"value":"2573-8348","type":"print"},{"value":"2573-8348","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1]]},"assertion":[{"value":"2024-08-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-01-09","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-01-29","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70124"}}