Trapezius Flap Reconstruction of Scalp Defect After Removal of Occipital Fibrosarcoma in Neurofibromatosis Type I Patient

Kantenga Dieu Merci Kabulo

doi:10.11648/j.ijnpt.20170305.12

Abstract

Neurofibromatosis type 1 (NF1) is an autosomal dominant condition affecting approximately 1 in 3000 live births. The manifestations of this condition are extremely variable, even within families, and genetic counseling is consequently difficult with regard to prognosis. Individuals with NF1 are acknowledged to be at increased risk of malignancy. Several studies have previously attempted to quantify this risk, but have involved relatively small study populations. Soft tissue tumors represent a heterogeneous group of mesenchymal and neural lesions. We report a case of giant scalp Fibrosarcoma of the scalp in patient with neurofibromatosis type I without intracranial extension, in a 35 year old female which was excised completely along with the involved overlying skin, and reconstruction was done to cover the defect using trapezius flap and split thickness skin graft from the right thigh. She is doing well after treatment and is in regular follow up while awaiting further management by the oncologists.

Highlights

Soft tissue sarcomas are a group of heterogeneous tumors that have their origin primarily in the embryonic mesoderm; more than 50 histological subtypes and diverse clinical behaviors have been identified [1]
Fibrosarcoma is defined as a malignant spindle cell tumor that shows a herringbone or interlacing fascicular pattern without the expression of other connective tissue cell markers [Sapp JP et al, 2004]
A month and half latter the patient was taken to theatre by plastic surgeons for trapezius flap to cover the defect, the flap was rotated to cover the exposed skull and the skin graft from the right thigh was used to cover the rest of the scalp defect with granulation tissue

Summary

Introduction

Soft tissue sarcomas are a group of heterogeneous tumors that have their origin primarily in the embryonic mesoderm; more than 50 histological subtypes and diverse clinical behaviors have been identified [1]. Soft-tissue sarcomas are relatively rare in the head and neck. They account for 4–15% of all soft-tissue sarcomas and less than 10% of all neoplasms at this site. The reconstructive options for a posterior scalp defect can usually be determined on the basis of the size of the wound. Kantenga Dieu Merci Kabulo et al.: Trapezius Flap Reconstruction of Scalp Defect After Removal of Occipital. Pedicled or free tissue transfers may be required to provide coverage for large defects as well. Some of the notable options include a latissimus dorsi free flap, a pedicled trapezius myocutaneous flap, an anterolateral thigh flap, or an omental flap [6, 7]

Case Presentation

Findings

Discussion

Conclusion