en گوش و حلق و بینی Otolaryngology_ENT گزارش مورد Case Report <span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><b><span style="font-size:10.0pt"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="color:black">Introduction:</span></span></span></b><span style="font-size:10.0pt"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="color:black"> Giant basal cell carcinoma (GBCC) of the face is a rare condition that requires both proper oncologic control and acceptable aesthetic outcomes, which is a significant challenge due to the complex reconstructive demands of the post-excision defect.</span></span></span></span></span><br> <span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><b><span style="font-size:10.0pt"><span style="font-family:&quot;Times New Roman&quot;,serif">Case Report:</span></span></b><span style="font-size:10.0pt"><span style="font-family:&quot;Times New Roman&quot;,serif"> A male patient in his late 60s presented with an ulcerated GBCC measuring <strong><span style="font-weight:normal">4.5 <a name="_Hlk232976216">&times;</a> 6 cm</span></strong> involving the right cheek. The diagnosis was confirmed preoperatively by punch <strong><span style="font-weight:normal">biopsy</span></strong><b>,</b> and surgical management was planned to obtain complete excision while addressing the anticipated aesthetic and functional sequelae of a large facial defect. Wide local excision was performed with a <strong><span style="font-weight:normal">1-cm margin</span></strong>, after which immediate reconstruction was conducted using a <strong><span style="font-weight:normal">regional bilobed rotation-advancement flap</span></strong>. The flap was designed to mobilize adjacent hair-bearing cervical skin to maximize tissue compatibility and restore the natural appearance of the involved facial subunit. Histopathologic examination confirmed <strong><span style="font-weight:normal">pigmented GBCC</span></strong> with clear margins and no perineural or lymphovascular invasion. Postoperatively, facial nerve function was maintained, healing was uneventful, and long-term follow-up indicated stable reconstruction without any evidence of recurrence.<span style="color:black"></span></span></span></span></span><br> <span style="font-size:11pt"><span style="tab-stops:9.0pt"><span style="font-family:Calibri,sans-serif"><b><span style="font-size:10.0pt"><span style="font-family:&quot;Times New Roman&quot;,serif">Conclusion:</span></span></b><span style="font-size:10.0pt"><span style="font-family:&quot;Times New Roman&quot;,serif"> This case highlights the bilobed rotation-advancement flap as an advantageous technique for reconstruction of selected sizable defects after excision of GBCC. The favorable long-term outcome indicates that, when properly planned, this technique can accomplish functional preservation, oncologic safety, and aesthetically acceptable restoration without the need for more extensive reconstructive procedures.</span></span><span dir="RTL" lang="AR-SA" style="font-size:10.0pt"><span style="font-family:&quot;Times New Roman&quot;,serif"></span></span></span></span></span><br> <span style="font-size:11pt"><span style="tab-stops:9.0pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:4.0pt"><span style="font-family:&quot;Times New Roman&quot;,serif"></span></span></span></span></span><br> <span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><b><span style="font-size:10.0pt"><span style="font-family:&quot;Times New Roman&quot;,serif">Key words:</span></span></b><span style="font-size:10.0pt"><span style="font-family:&quot;Times New Roman&quot;,serif"> Basal cell carcinoma (BCC), Bilobed rotation-advancement flap, Facial defect, Reconstructive surgical procedures</span></span></span></span> Basal cell carcinoma (BCC), Bilobed rotation-advancement flap, Facial defect, Reconstructive surgical procedures 0 0 http://jsurgery.bums.ac.ir/browse.php?a_code=A-10-555-1&slc_lang=en&sid=1 Batool sadat Sajadinejad b.sajadei@bums.ac.ir 100319475328460012747 100319475328460012747 No Department of Otorhinolaryngology, School of Medicine, Birjand University of Medical Sciences, Birjand, Iran Mahdi Mikaeeli mahdi.mikaeeli@bums.ac.ir 100319475328460012748 0009-0008-5810-2970 Yes Department of Surgical Technology, School of Allied Medicine, Birjand University of Medical Sciences, Birjand, Iran. Ehsan Hemmati hematy.ehsan@yahoo.com 100319475328460012749 0009-0000--275-4357 No Department of Anatomical Sciences, Faculty of Medicine, Tarbiat Modares University, Tehran, Iran