title: Widespread cutaneous angiosarcoma of the scalp: diagnosis and soft tissue reconstruction with a combined double-muscle-free flap and split-thickness-skin graft.
abstract: BACKGROUND
  Cutaneous angiosarcoma is a rare vascular tumor, which is usually located in the head and neck region. Because of the unspecific appearance, diagnoses are only secured after a histological examination of a tissue sample.
  
  
  METHODS
  After three punch biopsies, a 67-year-old patient, who had been healthy so far, was diagnosed with a cutaneous multilocated angiosarcoma of the scalp. Computed tomography of the head, neck, thorax, and abdomen was done for staging. It was without pathological findings. The tumor removal caused a scalp defect with a size of 30 x 30 cm. The cover of the defect was made by a combined microsurgical muscle flap with parts of the musculus latissimus dorsi and musculus serratus anterior. This flap was covered with split-thickness-skin in a second step. Eight weeks postoperative, the radiotherapy has started.
  
  
  CONCLUSIONS
  This kind of treatment can be recommended because the early reconstruction allowed a soon adjuvant radiotherapy, and the patient regained a good quality of life due to the pleasant and aesthetically result.
authors.affiliation: Klinikum Oldenburg gGmbH, Clinic for Maxillofacial Surgery and Plastic Surgery, Rahel-Straus-Str. 10, 26133, Oldenburg, Germany. gudewer.eva@klinikum-oldenburg.de
authors.forename: Eva
authors.initials: E
authors.lastname: Gudewer
authors.forename: Erhard
authors.initials: E
authors.lastname: Hölzle
authors.forename: Lei
authors.initials: L
authors.lastname: Li
mesh_terms: D000368:Aged; D001707:Biopsy, Needle / Q000379:methods; D006258:Head and Neck Neoplasms / Q000175:diagnosis / Q000601:surgery*; D006394:Hemangiosarcoma / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000379:methods; D018482:Muscle, Skeletal / Q000637:transplantation*; D009367:Neoplasm Staging; D018714:Radiotherapy, Adjuvant; D019651:Plastic Surgery Procedures / Q000379:methods*; D012535:Scalp / Q000473:pathology / Q000601:surgery*; D012878:Skin Neoplasms / Q000175:diagnosis / Q000601:surgery*; D016038:Skin Transplantation / Q000379:methods*; D013524:Surgical Flaps; D014057:Tomography, X-Ray Computed