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Salvage surgery and microsurgical reconstruction for recurrence of skull base osteosarcoma after carbon ion radiotherapy.

Kohyama K, Yamada K, Sugiura H, Hyodo I, Ozawa T, Hasegawa Y, Kato H, Kamei Y - Nagoya J Med Sci (2015)

Bottom Line: As the patient developed no postoperative wound complications, she was able to initiate adjuvant chemotherapy early.Although the affected field may be limited, its high potency may severely damage adjacent normal tissue and lead to serious postoperative complications.Despite these concerns, satisfactory results were achieved in this case.

View Article: PubMed Central - PubMed

Affiliation: Department of Plastic and Reconstructive Surgery, Gifu University Hospital, Gifu, Japan ; Department of Plastic and Reconstructive Surgery, Aichi Cancer Center Hospital, Nagoya, Japan.

ABSTRACT
Carbon ion radiotherapy has recently emerged as an alternative choice of treatment for malignant tumors of the head and neck. However, it is still in the infant stages and its influence on subsequent salvage surgery remains unclear. Here we report the case of a 43-year-old woman who underwent salvage surgery for left frontal bone osteosarcoma recurrence following carbon ion radiotherapy. Tumor resection was performed with a wide margin including the tissue considered to have been damaged by carbon ion radiotherapy. The dural defect was reconstructed using a fascia lata graft and pedicled galeal pericranial flap. The soft tissue defect was reconstructed using an anterolateral thigh flap anastomosed to the ipsilateral neck interposed by the radial forearm flap. As the patient developed no postoperative wound complications, she was able to initiate adjuvant chemotherapy early. Carbon ion radiotherapy is useful for its focused distribution and strong biological effects. Although the affected field may be limited, its high potency may severely damage adjacent normal tissue and lead to serious postoperative complications. Despite these concerns, satisfactory results were achieved in this case.

No MeSH data available.


Related in: MedlinePlus

Computed tomography scan of the head showing a frontal bone mass. (A) The mass was located in the left supraorbital area. (B) Low-density area indicated edema in the left frontal lobe.
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fig2: Computed tomography scan of the head showing a frontal bone mass. (A) The mass was located in the left supraorbital area. (B) Low-density area indicated edema in the left frontal lobe.

Mentions: CT of the head revealed a 1.8×2.5 cm frontal bone mass (Figures 2A, B). A low-density area indicated edema in the left frontal lobe (Figure 2B). Compared to the images obtained after treatment, the mass was larger in size, with increased calcification. Needle biopsy was performed, and the pathologic diagnosis of osteosarcoma was confirmed. Stable disease was maintained for a prolonged period; the mass was clinically diagnosed as recurrence of osteosarcoma rather than residual disease.


Salvage surgery and microsurgical reconstruction for recurrence of skull base osteosarcoma after carbon ion radiotherapy.

Kohyama K, Yamada K, Sugiura H, Hyodo I, Ozawa T, Hasegawa Y, Kato H, Kamei Y - Nagoya J Med Sci (2015)

Computed tomography scan of the head showing a frontal bone mass. (A) The mass was located in the left supraorbital area. (B) Low-density area indicated edema in the left frontal lobe.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4664599&req=5

fig2: Computed tomography scan of the head showing a frontal bone mass. (A) The mass was located in the left supraorbital area. (B) Low-density area indicated edema in the left frontal lobe.
Mentions: CT of the head revealed a 1.8×2.5 cm frontal bone mass (Figures 2A, B). A low-density area indicated edema in the left frontal lobe (Figure 2B). Compared to the images obtained after treatment, the mass was larger in size, with increased calcification. Needle biopsy was performed, and the pathologic diagnosis of osteosarcoma was confirmed. Stable disease was maintained for a prolonged period; the mass was clinically diagnosed as recurrence of osteosarcoma rather than residual disease.

Bottom Line: As the patient developed no postoperative wound complications, she was able to initiate adjuvant chemotherapy early.Although the affected field may be limited, its high potency may severely damage adjacent normal tissue and lead to serious postoperative complications.Despite these concerns, satisfactory results were achieved in this case.

View Article: PubMed Central - PubMed

Affiliation: Department of Plastic and Reconstructive Surgery, Gifu University Hospital, Gifu, Japan ; Department of Plastic and Reconstructive Surgery, Aichi Cancer Center Hospital, Nagoya, Japan.

ABSTRACT
Carbon ion radiotherapy has recently emerged as an alternative choice of treatment for malignant tumors of the head and neck. However, it is still in the infant stages and its influence on subsequent salvage surgery remains unclear. Here we report the case of a 43-year-old woman who underwent salvage surgery for left frontal bone osteosarcoma recurrence following carbon ion radiotherapy. Tumor resection was performed with a wide margin including the tissue considered to have been damaged by carbon ion radiotherapy. The dural defect was reconstructed using a fascia lata graft and pedicled galeal pericranial flap. The soft tissue defect was reconstructed using an anterolateral thigh flap anastomosed to the ipsilateral neck interposed by the radial forearm flap. As the patient developed no postoperative wound complications, she was able to initiate adjuvant chemotherapy early. Carbon ion radiotherapy is useful for its focused distribution and strong biological effects. Although the affected field may be limited, its high potency may severely damage adjacent normal tissue and lead to serious postoperative complications. Despite these concerns, satisfactory results were achieved in this case.

No MeSH data available.


Related in: MedlinePlus