Reconstruction of Heel Defect Occured by Verrucous Carcinoma

Abstract

Verrucous carcinoma is a low-grade, well differentiated uncommon variant of squamous cell carcinoma and may grow large and can destroy adjacent tissue such as bone and cartilage. A 45-year-old male patient presented with chief complaints of growth mass of the left foot. He is known diabetic, hypertensive, chronic venous insufficiency and related ulcerations on the lower legs. There is a tender, ulcero-proliferative mass on foot. The result of biopsy showed a highly differentiated verrucous carcinoma. At first the patient underwent wide excision and biopsy with mesh split thickness skin graft. But after 4 months that surgery, verrucous carcinoma recurred with ulceration. Because tumor infiltrated the soft periosteal tissues and calcaneus, he need flap coverage or amputation. We decide to reconstruct heel with anterolateral thigh perforator free flap. The goal of heel reconstruction should be functional and aesthetic. Below knee amputation was not performed, so the patient's quality of life increased.