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Multiple giant scalp metastases of a follicular thyroid carcinoma.

Cupisti K, Ramp U, Raffel A, Krausch M, Rehders A, Knoefel WT - World J Surg Oncol (2008)

Bottom Line: The 14-months follow up is presented.We demonstrate another case with multicentric form.Because of its location and size a primary wound closure was not possible.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of General, Visceral and Pediatric Surgery, University Hospital, Heinrich-Heine-University of Düsseldorf, Germany. cupisti@uni-duesseldorf.de

ABSTRACT

Background: The occurrence of skin metastases are rare events in the course of a follicular thyroid carcinoma (FTC) and usually indicate advanced tumor stages. The scalp is the most affected area of these metastases.

Case presentation: We present a case of a 76 year old Woman with multiple giant scalp metastases of a follicular carcinoma. These metastases had been resected and wounds had been closed with mesh graft. The 14-months follow up is presented.

Conclusion: We demonstrate another case with multicentric form. Because of its location and size a primary wound closure was not possible. A healing could be reached using vacuum therapy and mesh graft transplantation.

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Related in: MedlinePlus

Mesh Graft transplants. a) Retroauricular mesh graft transplant; b) Parietal mesh graft transplant.
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Figure 4: Mesh Graft transplants. a) Retroauricular mesh graft transplant; b) Parietal mesh graft transplant.

Mentions: A 76-year old female patient had the initial diagnosis of FTC 18 years ago. She had total thyroidectomy with bilateral neck dissection and multiple reoperations for recurrent tumor. Because of an irresectable local recurrence with tracheal infiltration a tracheotomy was performed two years ago. Five sets of internal radiation therapy, had been performed one year ago with a cumulative activity of 55.400 MBq131I. She was admitted to our hospital because of four intensively vascularized scalp tumors, two of them of hen's egg size (Fig. 1a, b, and 2) which showed recurrent episodes of contact bleeding during hair dressing. Computed tomography revealed multiple pulmonary, hepatic and bone metastases. Thyreoglobulin level was highly elevated (6750 ng/ml) Nevertheless the patient was in a good general condition. We performed a resection of the scalp tumors under general anesthesia. Histopathology confirmed cutaneous metastases of FTC (Fig. 3). The places of resection were primary left for granulation. After achievement of a clean granulation area using vacuum therapy (V.A.C.®, KCI International, Amsterdam, The Netherlands) we performed a mesh graft skin transplant (Fig. 4a, b).


Multiple giant scalp metastases of a follicular thyroid carcinoma.

Cupisti K, Ramp U, Raffel A, Krausch M, Rehders A, Knoefel WT - World J Surg Oncol (2008)

Mesh Graft transplants. a) Retroauricular mesh graft transplant; b) Parietal mesh graft transplant.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2533320&req=5

Figure 4: Mesh Graft transplants. a) Retroauricular mesh graft transplant; b) Parietal mesh graft transplant.
Mentions: A 76-year old female patient had the initial diagnosis of FTC 18 years ago. She had total thyroidectomy with bilateral neck dissection and multiple reoperations for recurrent tumor. Because of an irresectable local recurrence with tracheal infiltration a tracheotomy was performed two years ago. Five sets of internal radiation therapy, had been performed one year ago with a cumulative activity of 55.400 MBq131I. She was admitted to our hospital because of four intensively vascularized scalp tumors, two of them of hen's egg size (Fig. 1a, b, and 2) which showed recurrent episodes of contact bleeding during hair dressing. Computed tomography revealed multiple pulmonary, hepatic and bone metastases. Thyreoglobulin level was highly elevated (6750 ng/ml) Nevertheless the patient was in a good general condition. We performed a resection of the scalp tumors under general anesthesia. Histopathology confirmed cutaneous metastases of FTC (Fig. 3). The places of resection were primary left for granulation. After achievement of a clean granulation area using vacuum therapy (V.A.C.®, KCI International, Amsterdam, The Netherlands) we performed a mesh graft skin transplant (Fig. 4a, b).

Bottom Line: The 14-months follow up is presented.We demonstrate another case with multicentric form.Because of its location and size a primary wound closure was not possible.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of General, Visceral and Pediatric Surgery, University Hospital, Heinrich-Heine-University of Düsseldorf, Germany. cupisti@uni-duesseldorf.de

ABSTRACT

Background: The occurrence of skin metastases are rare events in the course of a follicular thyroid carcinoma (FTC) and usually indicate advanced tumor stages. The scalp is the most affected area of these metastases.

Case presentation: We present a case of a 76 year old Woman with multiple giant scalp metastases of a follicular carcinoma. These metastases had been resected and wounds had been closed with mesh graft. The 14-months follow up is presented.

Conclusion: We demonstrate another case with multicentric form. Because of its location and size a primary wound closure was not possible. A healing could be reached using vacuum therapy and mesh graft transplantation.

Show MeSH
Related in: MedlinePlus