title: Salvage surgery and microsurgical reconstruction for recurrence of skull base osteosarcoma after carbon ion radiotherapy.
abstract: Carbon ion radiotherapy has recently emerged as an alternative choice of treatment for malignant tumors of the head and neck. However, it is still in the infant stages and its influence on subsequent salvage surgery remains unclear. Here we report the case of a 43-year-old woman who underwent salvage surgery for left frontal bone osteosarcoma recurrence following carbon ion radiotherapy. Tumor resection was performed with a wide margin including the tissue considered to have been damaged by carbon ion radiotherapy. The dural defect was reconstructed using a fascia lata graft and pedicled galeal pericranial flap. The soft tissue defect was reconstructed using an anterolateral thigh flap anastomosed to the ipsilateral neck interposed by the radial forearm flap. As the patient developed no postoperative wound complications, she was able to initiate adjuvant chemotherapy early. Carbon ion radiotherapy is useful for its focused distribution and strong biological effects. Although the affected field may be limited, its high potency may severely damage adjacent normal tissue and lead to serious postoperative complications. Despite these concerns, satisfactory results were achieved in this case.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Gifu University Hospital, Gifu, Japan ; Department of Plastic and Reconstructive Surgery, Aichi Cancer Center Hospital, Nagoya, Japan.
authors.forename: Keishi
authors.initials: K
authors.lastname: Kohyama
authors.affiliation: Department of Orthopaedic Surgery, Aichi Cancer Center Hospital, Nagoya, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Yamada
authors.affiliation: Department of Orthopaedic Surgery, Aichi Cancer Center Hospital, Nagoya, Japan.
authors.forename: Hideshi
authors.initials: H
authors.lastname: Sugiura
authors.affiliation: Department of Plastic and Reconstructive Surgery, Aichi Cancer Center Hospital, Nagoya, Japan.
authors.forename: Ikuo
authors.initials: I
authors.lastname: Hyodo
authors.affiliation: Department of Head and Neck Surgery, Aichi Cancer Center Hospital, Nagoya, Japan.
authors.forename: Taijiro
authors.initials: T
authors.lastname: Ozawa
authors.affiliation: Department of Head and Neck Surgery, Aichi Cancer Center Hospital, Nagoya, Japan.
authors.forename: Yasuhisa
authors.initials: Y
authors.lastname: Hasegawa
authors.affiliation: Department of Plastic and Reconstructive Surgery, Gifu University Hospital, Gifu, Japan.
authors.forename: Hisakazu
authors.initials: H
authors.lastname: Kato
authors.affiliation: Department of Plastic and Reconstructive Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Yuzuru
authors.initials: Y
authors.lastname: Kamei
keywords: carbon ion radiotherapy; microsurgery; osteosarcoma; salvage surgery; skull base