Report on immediate irradiation of a rapidly growing sarcoma of the scalp prior to wound closure.
Cutaneous sarcomas are primarily treated with extensive surgery, and occasionally require adjuvant radiation therapy following complete wound healing. Thus, sarcoma surgery leads to large and deep wounds, and the initiation of adjuvant radiation therapy depends on the time required for defect closure. We present the case of a male patient with pleomorphic sarcoma of the temporal skin, which was treated with multiple wide and deep excisions, instant application of an Integra(®) bilayer, and immediate radiation therapy prior to wound closure. The objective was to investigate the usefulness of a dermal substitute (Integra(®) ) in accelerating the effect of adjuvant radiation therapy on scalp defects after tumor surgery. A ring-shaped skin area - at risk for recurrence - around the Integra(®) bilayer was irradiated with a total of 59.4 Gy. No necrosis, infection, or major radiotoxicity was observed, and a subsequent split skin graft following radiation therapy remained fully vital until complete healing. In conclusion, a combined procedure consisting of sequential tumor surgery and subsequent application of a dermal substitute in conjunction with immediate initiation of adjuvant radiation therapy is, in principle, possible, and may permit innovative therapeutic options in dermatooncology and dermatosurgery.
Department of Dermatology, Saarland University Hospital Homburg/Saar, Germany.
Cornelia Sigrid Lissi
CS
Müller
Department of Dermatology, Saarland University Hospital Homburg/Saar, Germany.
Janina
J
Jungmann
Department of Dermatology, Saarland University Hospital Homburg/Saar, Germany.
Claudia
C
Pföhler
Department of Radiotherapy and Radiation Oncology, Saarland University Hospital Homburg/Saar, Germany.
Farid
F
Mohammad
Department of Radiotherapy and Radiation Oncology, Saarland University Hospital Homburg/Saar, Germany.
Christian
C
Rübe
Department of Dermatology, Saarland University Hospital Homburg/Saar, Germany.
Thomas
T
Vogt
D002809:Chondroitin Sulfates; D003094:Collagen; D006801:Humans; D008297:Male; D009364:Neoplasm Recurrence, Local; D012509:Sarcoma / Q000601:surgery*; D012535:Scalp; D012878:Skin Neoplasms / Q000601:surgery*; D016038:Skin Transplantation; D017768:Skin, Artificial
D002809:Chondroitin Sulfates; D003094:Collagen
Integra; cancer reconstruction; dermal substitute; dermal template; full-thickness defects; radiotherapy; sarcoma; skin cancer; surgery