Lower Eyelid Cutaneous Squamous Cell Carcinoma: Oncologic Resection and Reconstruction With a Mustardé Rotation Flap

Periocular cutaneous squamous cell carcinoma can lead to local invasion, recurrence, and regional dissemination; therefore, its management must combine complete oncological resection with a reconstruction that preserves ocular protection. We present the case of a 75-year-old male agricultural worker with an irregular, ulcerated lesion measuring approximately 10 × 12 mm on the lower eyelid, with a three-month evolution. No regional lymphadenopathy or clinical evidence of orbital involvement or metastatic disease was identified. A wide excision of the lesion was performed, resulting in a 30 × 15 mm defect, followed by immediate reconstruction using a Mustardé dermocutaneous rotation flap. The definitive histopathological examination confirmed a moderately differentiated squamous cell carcinoma (G2) without lymphovascular, perineural, or deep structure invasion, with negative surgical margins and a minimum distance of 9 mm. The immediate and outpatient postoperative course was favorable, demonstrating flap viability, continuity of the cutaneous coverage, and no evident early complications. This case demonstrates the integration of oncological resection with histological margin control and immediate reconstruction using a Mustardé flap for cutaneous defects of the lower eyelid.