Squamous cell carcinoma of the perineum: management with Mohs' surgical excision and gluteal thigh flap.

Two patients with squamous cell carcinoma of the perineum are presented. The carcinomas were treated by wide local excision using Mohs' fresh-tissue technique for control of the surgical margins. The wounds were closed using a gluteal thigh flap. In 1 patient the flap was extended across the midline for coverage of a contralateral perineal site. Healing was complete in each case. The combination of Mohs' fresh-tissue methods and the posterior thigh flap provided accurate identification and removal of the perineal tumor with stable wound coverage.