Dual-flap reconstruction for extensive primary mucinous carcinoma of the eyelid: A case report

Primary mucinous carcinoma (PMC) is a very rare tumor, especially in the eyelids. As full-thickness excision with at least 5-mm margins is needed to minimize recurrence, the surgical approach is challenging due to the limited availability of palpebral tissue for preserving function and aesthetics. We report a case of an atypically large PMC of the left upper eyelid, in which its wide local excision led to a palpebral defect of more than 50% involving the lateral canthus. The defect was subsequently reconstructed using a combination of the Advancement and Cutler-Beard flaps, yielding remarkable results in both functional restoration and aesthetic outcomes. To the best of our knowledge, this is the first reported case of PMC of the eyelid involving the lateral canthus that requires this combination of reconstructive strategies. This case report highlights the atypical presentation of PMC, the need for a personalized reconstructive approach, and its potential outcomes, further raising awareness of this rare tumor entity.