[Tumor of the hand, free flap and irradiation. Anatomo-pathologic study apropos of 1 case].
After excision of a recurrent squamous cell carcinoma of the ulnar border of the right hand and forearm, we covered the defect with a free scapular flap. The flap and the tumor site were irradiated post-operatively (4 000 Rad). In spite of the irradiation the tumor recurred and we performed a below elbow amputation. Angiography of the amputated part showed the patency of all the flap vessels. However the histological features confirming the effect of the radiotherapy, particularly on the vessels, showed intimal proliferation and signs of necrosis of the media. We concluded that despite these findings the viability of free flaps is not jeopardized by radiotherapy, as long as their size is not reduced by more than 30% as compared to normal, and as long as the vascular anastomoses are done outside of the field of irradiation.
D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000628:therapy*; D003131:Combined Modality Therapy; D006225:Hand; D006801:Humans; D008297:Male; D009364:Neoplasm Recurrence, Local; D012878:Skin Neoplasms / Q000473:pathology / Q000628:therapy*; D013524:Surgical Flaps
Tumeur de la main, lambeau libre et irradiation. Etude anatomo-pathologique à propos d'un cas.