We report a rare case of a large facial microcystic adnexal carcinoma in an elderly patient who underwent several rounds of excision. The patient was left with a large facial defect and remaining positive margins. The decision was made to stop further excision and proceed with reconstructive surgery. We show that the patient’s function and quality of life were not impeded despite reconstruction in light of positive margins for tumor. We believe that this case will draw the surgeon’s attention to the possibility of palliative reconstruction in the treatment of a patient with large debilitating facial defects after microcystic adnexal carcinoma excision.
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