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[Surgical treatment of scalp malignant tumor]
Yong Qing1, Ying Cen, Huaisheng Wang
1Department of Burn and Plastic Surgery, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P.R. China.
Objective:
To investigate the effects of different surgical methods in treating scalp malignant tumors.
Methods:
From January 1995 to September 2004, 70 patients with scalp malignant tumor were treated with different surgical methods. There were 41 males and 29 females withan average age of 50.3 years (30-85 years). The course of disease ranged from 2 weeks to 3 years (mean 3.5 months). There were 31 cases of basal cell carcinoma, 24 cases of squamous carcinoma, 8 cases of melanocarcinoma, 4 cases of fibrous sarcoma, 2 cases of liposarcoma, and 1 case of vasculosarcoma. Leision size ranged from 1.0 cm x 0.5 cm to 10.0 cm x 8.0 cm. Scalp defect ranged from 3 cm x 3 cm to 12 cm x 11 cm after clearing up the tumors. Defect was repaired withfree skin transplantation in 51 cases, scalp flap in 12 cases, cervico-shoulder flap in 2 cases, trapizius myocutaneous flap in 3 cases, and radial artery retro-island flap in 2 cases. The flap sizes ranged from 5 cm x 4 cm to 18 cm x 12 cm.
Results:
Of 70 cases, 67 skin flaps survived and incision healed by first intention; 2 flaps necrosed at distal part (< 1 cm) and healed by second intention after dressing change; 1 flap infected and was treated with symptomatic medication. All the donor sites healed by first intention. Fifty-five patients were followed up for 1 to 5 years and 5 cases had tumor recurrence. In patients receiving skin transplantation, 1 case of squamous carcinoma and 1 case of fibrous sarcoma relapsed after 1 year and 2.5 years respectively and were given radical resection and skin flap grafting; in patients receiving skin flap grafting, 1 case of vasculosarcoma and 1 case of squamous carcinoma relapsed after 6 months and 3 months respectively, and gave up treatment; 1 case of fibrous sarcoma relapsed after 2 years and was given radical resection and skin flap grafting. The other cases survived and had no tumor recurrence.
Conclusion:
Scalp malignant tumors should be diagnosised and treated as early as possible. Clearing up completely by surgery is an effective method.
