Total Lower Eyelid Reconstruction Due to Clear Cell Hidroadenocarcinoma

Introduction: To discuss the surgical management of near-total defects due to clear cell hidroadenocarcinoma, a rare tumor of the lower eyelid, and to contribute to the limited literature on reconstruction options in this area. Materials and Methods: A 93-year-old female patient presented with a rapidly growing lesion on her left lower eyelid. Histopathological examination confirmed a diagnosis of malignant clear cell hidroadenocarcinoma. The tumor was excised with wide total excision under general anesthesia. The resultant defect was reconstructed using a full-thickness mucosal graft from the soft palate and a Mustarde cheek advancement flap. Postoperative medial canthus revision was performed with a local flap. Results: Postoperative follow-ups revealed complete eyelid closure and sufficient tear drainage. Functional and aesthetic outcomes were satisfactory. Due to the patient's advanced age and general condition, no radiotherapy or chemotherapy was applied, and a follow-up process was recommended. Conclusion: Clear cell hidroadenocarcinoma is a rare and aggressive malignant tumor. Mustarde cheek advancement flap is a suitable option for repairing extensive defects in the lower eyelid, especially in elderly patients, as it provides adequate tissue support. Detailed reporting of such cases contributes to the literature and aids in the management of this rare tumor.