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Angiosarcoma on Untreated Facial Capillary Malformations.

Nishibayashi A, Hata Y, Hori Y, Tomita K, Matsuda K, Yano K, Hosokawa K - Eplasty (2015)

View Article: PubMed Central - PubMed

Affiliation: Department of Plastic and Reconstructive Surgery, Osaka University Graduate School of Medicine, Yamadaoka, Suita-city, Osaka, Japan.

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Complete resection of these lesions is very difficult, as is the case for other malignant facial tumors... Complete surgical resection with wide margins is preferred for localized disease, although the safety margin for excising angiosarcomas is not clear... One study reported that a margin greater than 3 cm wide is necessary for high-grade sarcomas... Complete resection was particularly difficult in our case patient because the angiosarcoma occurred on a capillary malformation, making it challenging to identify the border between normal tissue and the malignant tumor... There are several ways to reconstruct a huge facial defect after resection of facial soft tissue (eg, full-thickness skin graft, split-thickness skin graft, free flap transfer)... Bleeding underneath the skin graft prevents adaptation... In our case, the defect was very deep and prone to bleeding, leading to the use of an anterolateral thigh flap... Unfortunately, the color did not match due to differences in the color of the thigh and face... Kim et al reported that a split-thickness skin graft is an option for wide wounds after the resection of facial capillary malformations... Facial capillary malformations become darker with age and can occasionally progress and lead to severe bleeding... This may complicate the diagnosis of angiosarcomas on capillary malformations... The diagnosis of angiosarcoma was delayed in our patient, in part, because circulatory failure of hypertrophic soft tissue on the port-wine stain was considered to be the cause of the bleeding ulceration, rather than a malignant neoplasm... Given that little is known about angiosarcomas, their treatment remains challenging.

No MeSH data available.


After reconstruction using an anterolateral thigh flap. The flap covered the entire raw surface but was swelled and bulky.
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Figure 3: After reconstruction using an anterolateral thigh flap. The flap covered the entire raw surface but was swelled and bulky.

Mentions: A 73-year-old man with a right facial capillary malformation with ulcerations and uncontrollable oozing was referred to our institution. Bleeding was temporarily controlled but could not be stopped (Fig 1). Anemia worsened daily, leading us to resect the port-wine stain on the right cheek (Fig 2). The subcutaneous defect was covered with a free anterolateral thigh flap (Fig 3). Bleeding stopped 1 week postoperatively. However, a new ulcer, identified as an angiosarcoma, appeared on the residual port-wine stain on the lip and bleeding resumed. The patient refused additional treatment and died of blood loss 38 days postoperatively.


Angiosarcoma on Untreated Facial Capillary Malformations.

Nishibayashi A, Hata Y, Hori Y, Tomita K, Matsuda K, Yano K, Hosokawa K - Eplasty (2015)

After reconstruction using an anterolateral thigh flap. The flap covered the entire raw surface but was swelled and bulky.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4482199&req=5

Figure 3: After reconstruction using an anterolateral thigh flap. The flap covered the entire raw surface but was swelled and bulky.
Mentions: A 73-year-old man with a right facial capillary malformation with ulcerations and uncontrollable oozing was referred to our institution. Bleeding was temporarily controlled but could not be stopped (Fig 1). Anemia worsened daily, leading us to resect the port-wine stain on the right cheek (Fig 2). The subcutaneous defect was covered with a free anterolateral thigh flap (Fig 3). Bleeding stopped 1 week postoperatively. However, a new ulcer, identified as an angiosarcoma, appeared on the residual port-wine stain on the lip and bleeding resumed. The patient refused additional treatment and died of blood loss 38 days postoperatively.

View Article: PubMed Central - PubMed

Affiliation: Department of Plastic and Reconstructive Surgery, Osaka University Graduate School of Medicine, Yamadaoka, Suita-city, Osaka, Japan.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Complete resection of these lesions is very difficult, as is the case for other malignant facial tumors... Complete surgical resection with wide margins is preferred for localized disease, although the safety margin for excising angiosarcomas is not clear... One study reported that a margin greater than 3 cm wide is necessary for high-grade sarcomas... Complete resection was particularly difficult in our case patient because the angiosarcoma occurred on a capillary malformation, making it challenging to identify the border between normal tissue and the malignant tumor... There are several ways to reconstruct a huge facial defect after resection of facial soft tissue (eg, full-thickness skin graft, split-thickness skin graft, free flap transfer)... Bleeding underneath the skin graft prevents adaptation... In our case, the defect was very deep and prone to bleeding, leading to the use of an anterolateral thigh flap... Unfortunately, the color did not match due to differences in the color of the thigh and face... Kim et al reported that a split-thickness skin graft is an option for wide wounds after the resection of facial capillary malformations... Facial capillary malformations become darker with age and can occasionally progress and lead to severe bleeding... This may complicate the diagnosis of angiosarcomas on capillary malformations... The diagnosis of angiosarcoma was delayed in our patient, in part, because circulatory failure of hypertrophic soft tissue on the port-wine stain was considered to be the cause of the bleeding ulceration, rather than a malignant neoplasm... Given that little is known about angiosarcomas, their treatment remains challenging.

No MeSH data available.