Thirty something year old with total lower lip reconstruction following excision of Squamous Cell carcinoma (SCCa) lower lip Mohs. Perineural invasion was seen on a shave biopsy. Mohs identified cancer cell infiltration near the nerves but no perineural lymphatic invasion or tumor cells within the nerve. This is the case of sensory nerves getting in the way of aggressively spreading SCCa. Patient lost 80% of the lower lip width and required a complex reconstruction with bilateral mentolabial myocutaneous neurovascular flaps and mucosal advancement.
CT/PET scan recommended 3-6 months post-op. Radiation was not recommended.