ABSTRACT
The authors report a case of navigation-guided tumour ablation of a high-grade epithelial-myoepithelial carcinoma of the right parotid gland extending to the skull base. Immediate functional reconstruction of the mandible with a prosthetic temporomandibular joint and facial nerve was performed. Postoperative follow-up showed no evidence of local tumour recurrence or distant metastasis with satisfactory temporomandibular and facial nerve function.
Subject(s)
Carcinoma/surgery , Parotid Neoplasms/surgery , Plastic Surgery Procedures/methods , Surgery, Computer-Assisted , Carcinoma/secondary , Chemotherapy, Adjuvant , Facial Nerve/surgery , Follow-Up Studies , Humans , Imaging, Three-Dimensional , Joint Prosthesis , Lymphatic Metastasis/pathology , Magnetic Resonance Imaging , Male , Mandible/surgery , Mandibular Condyle/surgery , Middle Aged , Neck Dissection , Neoplasm Invasiveness , Neoplasm Staging , Radiotherapy, Adjuvant , Skull Base/pathology , Temporomandibular Joint/surgery , Tomography, X-Ray ComputedABSTRACT
PURPOSE: To review the role of free tissue transfer in reconstructive surgery following resection of high-grade soft-tissue sarcomas of the lower limb. METHODS: Medical records of all consecutive patients with high-grade soft-tissue sarcomas of the lower limbs between August 1997 and September 2003 were reviewed. RESULTS: Of 8 patients (6 women and 2 men) aged between 19 and 65 years, 4 had malignant fibrous histiocytoma, one had malignant peripheral nerve sheath tumour, one had synovial sarcoma, one had recurrent liposarcoma, and one had epitheloid sarcoma. The tumour sizes ranged from 132 cm(2) to 483 cm(2). The soft-tissue defects following tumour extirpation ranged from 153 cm(2) to 896 cm(2). The flaps used were 3 free latissimus dorsi flaps, 2 free osteoseptocutaneous fibula flaps (one vascularised fibula flap and one 'double barrel' fibula flap), one free rectus abdominis flap, 2 free mini-transverse rectus abdominis flaps, and one pedicled rectus abdominis flap. Five patients did not have local recurrence and systemic metastases. CONCLUSION: Tissue transfer allows early adjuvant therapy facilitating the multimodal approach for the high-grade soft-tissue sarcomas of the lower extremity.