Alternative methods of skull reconstruction for giant sarcomas

Abstract

Soft tissue sarcomas are malignant tumors derived from the mesoderm, the most frequent age of presentation is between the 5th and 7th decade of life, mostly in males, more frequent location in the extremities, leaving only 1% of presentation in skin hairy, and this is a new concept of treating big sarcomas. We present the case of a 45-year-old male with a diagnosis of soft tissue sarcoma on the frontal, parietal, and right occipital surface of approximately 35x28x25 cm, without involvement of adjacent organs, without adjuvant therapy. Performing an oncological resection, exposing the periosteum, performing fenetrations of the external table, covering the Dermal Matrix – Integra®, using a new concept to treat this large defects, after 3 weeks with complete neodermis, we cover it with a Partial Thickness Graft, achieving 100% integration. and proper follow-up. Sarcomas are an uncommon and heterogeneous group of neoplasms of mesenchymal origin. Standard use of Integra reconstruction requires two stages: Integra forms a neo dermis through ingrowth of host vessels, followed by application of a thin split-thickness skin graft at a later date <30 days, using this new concepts of treating large defects with no flap. Sarcomas are highly aggressive and have very varied symptoms depending on the tumor stage at the time of diagnosis. Timely and improved a new concept of treatment such as an Integra® dermal regenerator, not using a flap, shows adequate integration in the patient and survival.

Keywords

• Dermal Matrix. Graft. Sarcoma.