title: [Large surgical resection of a shoulder sarcoma's and secure one stage reconstruction with lattissimi dorsi and serratus anterior flap. Updating about a case].
abstract: BACKGROUND
  The soft tissue sarcomas (STM) are tumors developed at the expense of connective tissue. They are rare and have severe prognosis. The principles of management are recalled through an extended case of shoulder sarcoma.
  
  
  METHODS
  A 48-year-old patient has a sarcoma of the right pectoralis major muscle confirmed by biopsy. After multidisciplinary meeting, a wide surgical excision exposing the subclavian vessels and brachial plexus is performed with double cover flap pedicled latissimus dorsi and serratus and thin skin graft.
  
  
  RESULTS
  Healing process is acquired at 3 months. Adjuvant chemotherapy is established (adriamycin, ifosfamide) along with radiotherapy (54Gy).
  
  
  CONCLUSIONS
  Sarcomas treatment has to be realized after considering multidisciplinary meeting (RCP) in dedicated structures. Surgery is the main treatment, it should ideally be R0, that is to say, integral with healthy tissue margin around the tumor (or healthy anatomical barrier). Optimal surgery performs a resection "without seen tumor". The diagnosis has to be made with a biopsy before the surgical treatment. Healing is quickly obtained due to adjuvant treatments.
authors.affiliation: Service de chirurgie orthopédique, traumatologique et plastique, chirurgie de la main, CHU Jean-Minjoz, 1, boulevard Flemming, 25030 Besançon, France.
authors.forename: J
authors.initials: J
authors.lastname: Haddad
authors.affiliation: Service de chirurgie vasculaire et de médecine vasculaire, CHU Jean-Minjoz, 1, boulevard Flemming, 25030 Besançon, France.
authors.forename: F
authors.initials: F
authors.lastname: Gouailler
authors.affiliation: Service de médecine physique et de réadaptation, soins de suite et de réadaptation, CHU Jean-Minjoz, 1, boulevard Flemming, 25030 Besançon, France.
authors.forename: E
authors.initials: E
authors.lastname: Aleton
authors.affiliation: Service d'oncologie médicale, CHU Jean-Minjoz, 1, boulevard Flemming, 25030 Besançon, France.
authors.forename: L
authors.initials: L
authors.lastname: Chaigneau
authors.affiliation: Service de chirurgie orthopédique, traumatologique et plastique, chirurgie de la main, CHU Jean-Minjoz, 1, boulevard Flemming, 25030 Besançon, France. Electronic address: julien.pauchot@gmail.com.
authors.forename: J
authors.initials: J
authors.lastname: Pauchot
mesh_terms: D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000637:transplantation*; D012509:Sarcoma / Q000601:surgery*; D012782:Shoulder / Q000601:surgery*; D012983:Soft Tissue Neoplasms / Q000601:surgery*; D013524:Surgical Flaps
keywords: Anterior surface of shoulder; Chirurgie d’exérèse; Double flap; Double lambeau; Exérèses inadaptées; Face antérieure de l’épaule; Inadequate excision; Netsarc network; Radiotherapy; Radiothérapie; Réseau NetSarc; Sarcoma soft tissues; Sarcomes des tissus mous; Surgical resection; Technical reconstructions; Techniques de reconstructions