Lim So-Young, Pyon Jai-Kyong, Mun Goo-Hyun, Bang Sa-Ik, Oh Kap-Sung
Department of Plastic and Reconstructive Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, Seoul, South Korea.
Ann Plast Surg. 2010 Feb;64(2):180-2. doi: 10.1097/SAP.0b013e3181a2c5e6.
Angiosarcomas of the scalp area are rare tumors mostly affecting elderly patients. In many series, potential treatment options for patients with scalp angiosarcoma have included surgery, radiation, and chemotherapy. Surgery combined with radiation therapy, however, did not appear to cure many patients. For these reasons, there is a serious need for the development of new approaches. We report our experience of 8 patients presenting angiosarcoma solely of the scalp. Our procedure consisted in radical tumor resection of the scalp with minimal 5-cm safety margins from the most peripheral scatted lesions with burring of the external table of the cranium, ipsilateral superficial parotidectomy, and ipsilateral upper neck dissection. After resection of the tumor of the scalp, the latissimus dorsi free flap was used for coverage of the defect. With prophylactic dissection of these regional lymph nodes, we could achieve better results and, at least, prolonged time to local recurrence and distant metastasis.
头皮区域的血管肉瘤是罕见肿瘤，主要影响老年患者。在许多病例系列中，头皮血管肉瘤患者的潜在治疗选择包括手术、放疗和化疗。然而，手术联合放疗似乎并不能治愈许多患者。基于这些原因，迫切需要开发新的治疗方法。我们报告了8例仅发生于头皮的血管肉瘤患者的治疗经验。我们的手术包括对头皮肿瘤进行根治性切除，从最外周散在病变起至少保留5厘米的安全切缘，同时对颅骨外板进行磨除，同侧腮腺浅叶切除术以及同侧上颈部淋巴结清扫术。切除头皮肿瘤后，采用背阔肌游离皮瓣覆盖缺损。通过对这些区域淋巴结进行预防性清扫，我们能够取得更好的治疗效果，至少可以延长局部复发和远处转移的时间。
