Scalp Reconstruction After Resection of a Large Recurred Proliferating Trichilemmal Tumor Using an Anterolateral Thigh Free Flap

In 2013, a 43-year-old woman with a large, ulcerated mass in the occipital area, diagnosed as a Proliferating Trichilemmal Tumor (PTT), underwent a radical resection of the recurred tumor with a 1 cm margin at the subperiosteal level. The tumor, which had grown from a small asymptomatic lesion over 15 years, was 13 cm×10 cm×5 cm in size. After the resection, the resulting defect was covered by an anterolateral thigh (ALT) free flap, a 15 cm×12 cm fasciocutaneous flap harvested from the patient's left thigh. The postoperative course was uneventful, and the free flap healed completely. The patient was satisfied with the aesthetic result, despite the absence of hair. No recurrence was observed for 8 months after surgery. The study concluded that ALT free flaps are a good option for resurfacing large full-thickness defects resulting from aggressive treatment of rare soft tissue tumors like PTTs.