Lower Island Trapezius Flap for a Rare Scalp Tumor

A 54-year-old male with a past history of acute pancreatitis and pulmonary embolism presented with a scalp tumor in the occipital region for a six-month duration. With a biopsy report of squamous cell carcinoma, wide local excision with the lower island trapezius myocutaneous flap with skin grafting was done. However, the final pathology report revealed a proliferating trichilemmal tumor with clear margins. The technique of the lower island trapezius flap in posterior scalp defects and a brief overview of proliferating trichilemmal tumors are described in this report.