J Korean Soc Plast Reconstr Surg.  2011 Sep;38(5):711-714.

Near Total Excision in Patients with Angiosarcoma on Scalp

Affiliations
  • 1Department of Plastic and Reconstructive Surgery, National Medical Center, Seoul, Korea. nmcps@unitel.co.kr

Abstract

PURPOSE
Angiosarcoma is a rare malignant neoplasm of endothelial type cells that line vessel walls. It tends to occur in aged male and the prognosis of angiosarcoma is very poor because of frequent local recurrence and early metastasis. The treatment regimen is yet to be established from its rare occurrence but the wide excision in early stage is known to be the most effective. The authors report two cases of near totally excised angiosarcoma with more than a safety margin of 5cm.
METHODS
The two subjects were aged male patients, one of the two was diagnosed with angiosarcoma from our institution confirmed by the biopsy. The other one went through the wide excision with a safety margin of 2cm and split-thickness skin graft but local recurrence was observed. The two patients underwent near total excision with more than a safety margin of 5cm, leaving only the periosteum. After confirming that the angiosarcoma had not infiltrated the excision margin, reconstruction with split-thickness skin graft was performed.
RESULTS
Based on 6 months and 24 months post-surgery assessment, no local recurrence or remote metastasis in the lungs, liver, bones, and lymph nodes at the neck, where remote metastasis is common, was reported by the two subjects who underwent near total excision with a safety margin of 5cm.
CONCLUSION
Angiosarcoma has very poor prognosis from its frequent recurrence and metastasis. To enhance the survival rate of angiosarcoma patients, early diagnosis, timely surgical treatment, and radiotherapy after surgery are critical. In addition, authors suggest that it is necessary to further study the efficacy of wide excision using a wider safety margin as much as possible, and to apply this to more cases.

Keyword

Angiosarcoma; Scalp; Total excision

MeSH Terms

Aged
Biopsy
Early Diagnosis
Glycosaminoglycans
Hemangiosarcoma
Humans
Liver
Lung
Lymph Nodes
Male
Neck
Neoplasm Metastasis
Periosteum
Prognosis
Recurrence
Scalp
Skin
Survival Rate
Transplants
Glycosaminoglycans
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