Cargando…

Surgical treatment of a case of recurrent irradiated basal cell carcinoma of the head with a large soft tissue and bone defect

Taking into account the great number of skin malignances that occur in the head and neck regions, problems related to their surgical treatment represent a constant concern for plastic surgeons. They have to deal with the difficulties of radical excision and also with reconstructive possibilities. Mo...

Descripción completa

Detalles Bibliográficos
Autores principales: Ioan Petre, Florescu, Giuglea, Carmen, Eugen, Turcu, Silviu, Marinescu, Crenguta, Jecan, Gorgan, Mircea, Narcisa, Bucur
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Carol Davila University Press 2009
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5052498/
https://www.ncbi.nlm.nih.gov/pubmed/20112470
_version_ 1782458239576702976
author Ioan Petre, Florescu
Giuglea, Carmen
Eugen, Turcu
Silviu, Marinescu
Crenguta, Jecan
Gorgan, Mircea
Narcisa, Bucur
author_facet Ioan Petre, Florescu
Giuglea, Carmen
Eugen, Turcu
Silviu, Marinescu
Crenguta, Jecan
Gorgan, Mircea
Narcisa, Bucur
author_sort Ioan Petre, Florescu
collection PubMed
description Taking into account the great number of skin malignances that occur in the head and neck regions, problems related to their surgical treatment represent a constant concern for plastic surgeons. They have to deal with the difficulties of radical excision and also with reconstructive possibilities. More than 2/3 of these malignances are basal cell carcinomas, which, if left untreated might become very invasive, surgical treatment being more difficult in such cases. Recurrent carcinomas combined with radiation injuries represent a serious challenge even for experienced surgeons regarding the size of the defect and anatomical structures involved. In this paper we present a case of a patient with basal cell carcinoma of the parietal region and the reconstructive treatment involving neurosurgery and plastic surgery team approach, using microsurgery techniques. We also present the difficulties of the case as well as the final outcome that we consider the best option for the patient. The neurosurgical stage consisted in fongus removal, excluding all brain tissue located outside the dural limits, craniectomy, duraplasty and cranioplasty. Because of the large size of the defect and also because the local resources were exhausted we chose as a covering solution the free tissue transfer consisting in a latissimus dorsi musculocutaneous flap. The difficulties of these cases consist both in the aim of radical excision and the limited reconstructive options. In this case, our collaboration with the neurosurgery team proved to be crucial, permitting us to solve this case in a single operative time, with deep excision, reconstruction of the dura mater and cranioplasty, and reconstruction of the soft tissues with microsurgical free transfer.
format Online
Article
Text
id pubmed-5052498
institution National Center for Biotechnology Information
language English
publishDate 2009
publisher Carol Davila University Press
record_format MEDLINE/PubMed
spelling pubmed-50524982016-10-21 Surgical treatment of a case of recurrent irradiated basal cell carcinoma of the head with a large soft tissue and bone defect Ioan Petre, Florescu Giuglea, Carmen Eugen, Turcu Silviu, Marinescu Crenguta, Jecan Gorgan, Mircea Narcisa, Bucur J Med Life Case Presentations Taking into account the great number of skin malignances that occur in the head and neck regions, problems related to their surgical treatment represent a constant concern for plastic surgeons. They have to deal with the difficulties of radical excision and also with reconstructive possibilities. More than 2/3 of these malignances are basal cell carcinomas, which, if left untreated might become very invasive, surgical treatment being more difficult in such cases. Recurrent carcinomas combined with radiation injuries represent a serious challenge even for experienced surgeons regarding the size of the defect and anatomical structures involved. In this paper we present a case of a patient with basal cell carcinoma of the parietal region and the reconstructive treatment involving neurosurgery and plastic surgery team approach, using microsurgery techniques. We also present the difficulties of the case as well as the final outcome that we consider the best option for the patient. The neurosurgical stage consisted in fongus removal, excluding all brain tissue located outside the dural limits, craniectomy, duraplasty and cranioplasty. Because of the large size of the defect and also because the local resources were exhausted we chose as a covering solution the free tissue transfer consisting in a latissimus dorsi musculocutaneous flap. The difficulties of these cases consist both in the aim of radical excision and the limited reconstructive options. In this case, our collaboration with the neurosurgery team proved to be crucial, permitting us to solve this case in a single operative time, with deep excision, reconstruction of the dura mater and cranioplasty, and reconstruction of the soft tissues with microsurgical free transfer. Carol Davila University Press 2009 /pmc/articles/PMC5052498/ /pubmed/20112470 Text en ©Carol Davila University Press http://creativecommons.org/licenses/by/2.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Presentations
Ioan Petre, Florescu
Giuglea, Carmen
Eugen, Turcu
Silviu, Marinescu
Crenguta, Jecan
Gorgan, Mircea
Narcisa, Bucur
Surgical treatment of a case of recurrent irradiated basal cell carcinoma of the head with a large soft tissue and bone defect
title Surgical treatment of a case of recurrent irradiated basal cell carcinoma of the head with a large soft tissue and bone defect
title_full Surgical treatment of a case of recurrent irradiated basal cell carcinoma of the head with a large soft tissue and bone defect
title_fullStr Surgical treatment of a case of recurrent irradiated basal cell carcinoma of the head with a large soft tissue and bone defect
title_full_unstemmed Surgical treatment of a case of recurrent irradiated basal cell carcinoma of the head with a large soft tissue and bone defect
title_short Surgical treatment of a case of recurrent irradiated basal cell carcinoma of the head with a large soft tissue and bone defect
title_sort surgical treatment of a case of recurrent irradiated basal cell carcinoma of the head with a large soft tissue and bone defect
topic Case Presentations
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5052498/
https://www.ncbi.nlm.nih.gov/pubmed/20112470
work_keys_str_mv AT ioanpetreflorescu surgicaltreatmentofacaseofrecurrentirradiatedbasalcellcarcinomaoftheheadwithalargesofttissueandbonedefect
AT giugleacarmen surgicaltreatmentofacaseofrecurrentirradiatedbasalcellcarcinomaoftheheadwithalargesofttissueandbonedefect
AT eugenturcu surgicaltreatmentofacaseofrecurrentirradiatedbasalcellcarcinomaoftheheadwithalargesofttissueandbonedefect
AT silviumarinescu surgicaltreatmentofacaseofrecurrentirradiatedbasalcellcarcinomaoftheheadwithalargesofttissueandbonedefect
AT crengutajecan surgicaltreatmentofacaseofrecurrentirradiatedbasalcellcarcinomaoftheheadwithalargesofttissueandbonedefect
AT gorganmircea surgicaltreatmentofacaseofrecurrentirradiatedbasalcellcarcinomaoftheheadwithalargesofttissueandbonedefect
AT narcisabucur surgicaltreatmentofacaseofrecurrentirradiatedbasalcellcarcinomaoftheheadwithalargesofttissueandbonedefect