Chronic Scalp Ulcer 35 Years after Skull Trepanation Surgery and Radiotherapy for Oligodendroglioma: A Further Example of Immunocompromised Cutaneous Districts

Authors

  • Uwe Wollina Städtisches Klinikum Dresden, Dresden, Sachsen, Germany; Academic Teaching Hospital Dresden-Friedrichstadt
  • Andreas Nowak Department of Anesthesiology & Intensive Care Medicine, Emergency Medicine & Pain Management, Dresden
  • Georgi Tchernev Medical Institute of Ministry of Interior (MVR), Department of Dermatology, Venereology and Dermatologic Surgery, Sofia; Onkoderma - Policlinic for Dermatology and Dermatologic Surgery, Sofia
  • Torello Lotti Università Degli Studi "G. Marconi”, Rome, Italy, Facoltà di Medicina e Chirurgia - Chair of Dermatology, University of Rome, Rome

DOI:

https://doi.org/10.3889/oamjms.2018.019

Keywords:

Chronic scalp ulcer, Oligodendroglioma, Second malignancy, Complex reconstruction, Immunocompromised cutaneous district

Abstract

BACKGROUND: Chronic ulcers of the scalp have a variety of underlying pathologies. In case of cancer patients, a second malignancy must be excluded.

CASE REPORT: A 78-year-old female patient presented to our department with a large soft tissue defect on the frontotemporal left side. The lesion was about 3 cm in diameter with exposed bone and inflammatory soft tissue on the edges of the defect. About 35 years ago, she had undergone a combined neurosurgery with skull trepanation and radiotherapy for an oligodendroglioma. Three years ago, sandwich transplantation with the dermal template and meshed skin graft failed. Now she re-presented with inflammatory ulcer borders. A complex defect repair was performed after exclusion of a second malignancy.

CONCLUSION: Chronic scalp ulcers may be the result immunocompromised cutaneous districts and need a complex reconstruction.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

Plum Analytics Artifact Widget Block

References

Wollina U. Basal cell carcinoma in the area of chronic radiodermatitis – 3 case reports with long-term follow-up. Georgian Med News. 2016; 254:7-10.

Disharoon M, Kozlowski KF, Kaniowski JM. Radiation-induced angiosarcoma. Radiology. 2017; 283(3):909-916. https://doi.org/10.1148/radiol.2017150456 PMid:28514220

Wollina U, Koch A, Hansel G, Schönlebe J, Kittner T, Pabst F, Haroske G, Nowak A. A 10-year analysis of cutaneous mesenchymal tumors (sarcomas and related entities) in a skin cancer center. Int J Dermatol. 2013; 52(10):1189-97. https://doi.org/10.1111/j.1365-4632.2012.05484.x

Yan F, Ye Z, Wang F, Wang L, Li W, Fu Z. Clinical and imaging characteristics of 53 ulcers of post-radiation nasopharyngeal necrosis in patients with nasopharyngeal carcinoma. Mol Clin Oncol. 2016; 5(4):351-356. https://doi.org/10.3892/mco.2016.968 PMid:27699026 PMCid:PMC5038583

Mirza F, Shamim MS. Extent of resection and timing of surgery in adult low grade glioma. J Pak Med Assoc. 2017; 67(6):959-961.

Brown TJ, Brennan MC, Li M, Church EW, Brandmeir NJ, Rakszawski KL, Patel AS, Rizk EB, Suki D, Sawaya R, Glantz M. Association of the extent of resection with survival in glioblastoma: A systematic review and meta-analysis. JAMA Oncol. 2016; 2(11):1460-1469. https://doi.org/10.1001/jamaoncol.2016.1373 PMid:27310651

Vissink A, Burlage FR, Spijkervet FK, Jansma J, Coppes RP. Prevention and treatment of the consequences of head and neck radiotherapy. Crit Rev Oral Biol Med. 2003; 14(3):213-25. https://doi.org/10.1177/154411130301400306 PMid:12799324

López Aventín D, Gil I, López González DM, Pujol RM. Chronic scalp ulceration as a late complication of fluoroscopically guided cerebral aneurysm embolization. Dermatology. 2012; 224(3):198-203. https://doi.org/10.1159/000338891 PMid:22677971

Wolf R, Wolf D, Ruocco V, Ruocco E. Wolf's isotopic response: The first attempt to introduce the concept of vulnerable areas in dermatology. Clin Dermatol. 2014; 32(5):557-60. https://doi.org/10.1016/j.clindermatol.2014.04.002 PMid:25160096

Ruocco V, Ruocco E, Piccolo V, Brunetti G, Guerrera LP, Wolf R. The immunocompromised district in dermatology: A unifying pathogenic view of the regional immune dysregulation. Clin Dermatol. 2014; 32(5):569-76. https://doi.org/10.1016/j.clindermatol.2014.04.004 PMid:25160098

Wollina U, Schönlebe J. Disseminated specific cutaneous infiltrates of B-cell chronic lymphocytic leukemia - Wolf's isotopic response following herpes zoster infection. J Dtsch Dermatol Ges. 2016; 14(2):179-81. https://doi.org/10.1111/ddg.12670

Wollina U. One-stage reconstruction of soft tissue defects with the sandwich technique: Collagen-elastin dermal template and skin grafts. J Cutan Aesthet Surg. 2011; 4(3):176-82. https://doi.org/10.4103/0974-2077.91248 PMid:22279382 PMCid:PMC3263127

Enei ML, Machado Filho Cd. Closure of chronic ulcer localized on the scalp previously irradiated using a fenestration technique. Dermatol Surg. 2015; 41(10):1196-8. https://doi.org/10.1097/DSS.0000000000000443 PMid:26317908

Koenen W, Goerdt S, Faulhaber J. Removal of the outer table of the skull for reconstruction of full-thickness scalp defects with a dermal regeneration template. Dermatol Surg. 2008; 34(3):357-63. PMid:18177396

Published

2017-12-31

How to Cite

1.
Wollina U, Nowak A, Tchernev G, Lotti T. Chronic Scalp Ulcer 35 Years after Skull Trepanation Surgery and Radiotherapy for Oligodendroglioma: A Further Example of Immunocompromised Cutaneous Districts. Open Access Maced J Med Sci [Internet]. 2017 Dec. 31 [cited 2024 Mar. 28];6(1):55-7. Available from: https://oamjms.eu/index.php/mjms/article/view/oamjms.2018.019

Most read articles by the same author(s)

<< < 1 2 3 4 5 6 7 8 9 10 > >>