Pioneering Radial Forearm Free Flap Reconstruction for Lip Cancer in a Young Patient in Ethiopia

Squamous cell carcinoma (SCC) of the lip is rare in young individuals, usually associated with chronic sun exposure, tobacco use, or genetic predisposition. We report a 20-year-old woman with epilepsy who developed lower lip SCC. This case is unique for its early onset and is the first lower lip reconstruction with a radial forearm free flap in Ethiopia. The patient underwent wide local excision, bilateral selective neck dissection (levels I-III), and radial forearm free flap reconstruction with a palmaris longus tendon sling. Postoperatively, recovery was uneventful with complete flap survival, improved oral competence, and restored speech. This case highlighted invasive SCC in a young patient and demonstrated the feasibility of free flap reconstruction in a resource-limited setting.