Key result
Wide local excision with craniectomy and latissimus dorsi flap reconstruction resulted in no local recurrence or distant metastasis over a two-year follow-up in a patient with recurrent angiosarcoma.
Case Report (n=1)
Wide local excision with free flap reconstruction can provide disease-free survival in recurrent angiosarcoma of the scalp.
Hypothesis-generating for reconstruction in recurrent scalp angiosarcoma; larger studies needed before practice change.
Angiosarcoma is a rare soft tissue tumour and forms less than 1% of all sarcomas. It usually occurs in the head and neck, and lesions in the scalp are seen in elderly people. Clinically, it varies from a small plaque to multifocal nodules and ulcers. The treatment varies with the extent of the disease. Most cases are treated with wide excision with reconstruction. Radiotherapy and chemotherapy is advised in the recurrent or extensive lesions with regional or distant metastasis. Recently, immunomodulation have been tried. Authors present a rare case of a 43-year-old female patient having bleeding scalp nodular lesions with ulcers. There was past history of nodular lesion over same area on scalp 17 years back which was diagnosed as angiosarcoma and was treated. On biopsy ulcerative nodular lesions were diagnosed as angiosarcoma. Wide local excision with craniectomy was done. Reconstruction using a latissimus dorsi flap was done at a second stage. The patient was not given postoperative radiotherapy or chemotherapy. There has been no recurrence for two years of follow-up.
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Banswal et al. (2014) conducted a case report in Recurrent angiosarcoma of the scalp (n=1). Wide local excision with craniectomy and latissimus dorsi flap reconstruction was evaluated on Local recurrence or distant metastasis. Wide local excision with craniectomy and latissimus dorsi flap reconstruction resulted in no local recurrence or distant metastasis over a two-year follow-up in a patient with recurrent angiosarcoma.
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