Paprottka Felix J, Klimas Dalius, Hebebrand Detlev
Department of Plastic, Aesthetic, Reconstructive and Hand Surgery, AGAPLESION Diakonieklinikum Rotenburg, Rotenburg (Wümme), Germany.
Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
Surg J (N Y). 2018 Jun 11;4(2):e87-e90. doi: 10.1055/s-0038-1660451. eCollection 2018 Apr.
Large and ulcerating skin tumors have become a rarity in the modern Western world. However, these conditions can cause serious life-threatening complications. The case of a 60-year-old male Caucasian patient is reported, who had suffered from an extensive basal cell carcinoma in the right shoulder region for several years. The patient kept the lesion secret from his friends and family and delayed presentation to health care services. After an episode of tumor-related heavy bleeding, the patient was referred to our clinic and received a radical surgical tumor resection-followed by defect coverage with a latissimus dorsi myocutaneous flap. An alternative treatment option that could be offered to the patient would have been a mutilating surgical procedure with an arm amputation. By using this plastic reconstructive surgical technique, the main function of the shoulder joint was conserved. The presented case demonstrates options for defect coverage of problematic wounds in anatomically complex body regions-like the shoulder-by using a functional reconstruction using myocutaneous flaps.
在现代西方世界,巨大且溃疡的皮肤肿瘤已较为罕见。然而,这些病症可能引发严重的危及生命的并发症。本文报告了一例60岁的男性白种人患者,其右肩部患有广泛性基底细胞癌数年。患者对朋友和家人隐瞒了该病灶,并延迟就医。在一次与肿瘤相关的大出血事件后,患者被转诊至我们的诊所,并接受了根治性手术肿瘤切除,随后采用背阔肌肌皮瓣覆盖缺损。原本可以为该患者提供的另一种治疗选择是进行截肢的致残性外科手术。通过运用这种整形重建外科技术,肩关节的主要功能得以保留。该病例展示了利用肌皮瓣进行功能重建,从而为解剖结构复杂的身体部位(如肩部)的疑难伤口覆盖缺损提供了多种选择。