Squamous cell carcinoma arising from an arteriovenous malformation of the scalp.
We present the case of a 70-year-old man with a congenital scalp lesion consistent with an arteriovenous malformation (AVM) which over the last 3 years had developed ulcerative changes and bleeding in the central aspect that was a biopsy proven squamous cell carcinoma (SCCA). To control hemorrhage during surgery, a radiologist performed selective embolization of major feeding arteries in the lesion three days before the surgery. After total resection of the lesion, a scalp reconstruction was performed by using a free latissimus muscle flap and skin graft. As a result, bleeding was well controlled, the AVM and SCCA were totally resected, and satisfactory aesthetic results were obtained. This appears to be the first description of a SCCA arising from a chronic AVM. This is suggestive of a possible Marjolin's ulcer from a chronic wound bed.
Thornton
Brian P
BP
Division of Plastic Surgery, University of Kentucky, Lexington Kentucky, USA. BrianThorntonMD@gmail.com
Sloan
David
D
Rinker
Brian
B
D000368:Aged; D001165:Arteriovenous Malformations / Q000473:pathology*; D002294:Carcinoma, Squamous Cell / Q000473:pathology*; D002471:Cell Transformation, Neoplastic / Q000473:pathology; D004621:Embolization, Therapeutic; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000473:pathology*; D006801:Humans; D008297:Male; D018482:Muscle, Skeletal / Q000637:transplantation; D019651:Plastic Surgery Procedures; D012535:Scalp / Q000098:blood supply* / Q000473:pathology; D012878:Skin Neoplasms / Q000473:pathology*; D016038:Skin Transplantation; D012883:Skin Ulcer / Q000473:pathology; D013524:Surgical Flaps