Large surgical resection of a shoulder sarcoma's and secure one stage reconstruction with lattissimi dorsi and serratus anterior flap. Updating about a case

The soft tissue sarcomas (STM) are tumors developed at the expense of connective tissue. They are rare and have severe prognosis. The principles of management are recalled through an extended case of shoulder sarcoma. A 48-year-old patient has a sarcoma of the right pectoralis major muscle confirmed...

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Published inAnnales de chirurgie plastique et esthétique Vol. 61; no. 4; pp. 302 - 306
Main Authors Haddad, J, Gouailler, F, Aleton, E, Chaigneau, L, Pauchot, J
Format Journal Article
LanguageFrench
Published France 01.08.2016
Subjects
Humans
Male
Middle Aged
Muscle, Skeletal - transplantation
Sarcoma - surgery
Shoulder - surgery
Soft Tissue Neoplasms - surgery
Surgical Flaps
Inadequate excision
Anterior surface of shoulder
Sarcomes des tissus mous
Sarcoma soft tissues
Radiothérapie
Réseau NetSarc
Surgical resection
Netsarc network
Double lambeau
Radiotherapy
Techniques de reconstructions
Double flap
Exérèses inadaptées
Face antérieure de l’épaule
Technical reconstructions
Chirurgie d’exérèse
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Summary:The soft tissue sarcomas (STM) are tumors developed at the expense of connective tissue. They are rare and have severe prognosis. The principles of management are recalled through an extended case of shoulder sarcoma. A 48-year-old patient has a sarcoma of the right pectoralis major muscle confirmed by biopsy. After multidisciplinary meeting, a wide surgical excision exposing the subclavian vessels and brachial plexus is performed with double cover flap pedicled latissimus dorsi and serratus and thin skin graft. Healing process is acquired at 3 months. Adjuvant chemotherapy is established (adriamycin, ifosfamide) along with radiotherapy (54Gy). Sarcomas treatment has to be realized after considering multidisciplinary meeting (RCP) in dedicated structures. Surgery is the main treatment, it should ideally be R0, that is to say, integral with healthy tissue margin around the tumor (or healthy anatomical barrier). Optimal surgery performs a resection "without seen tumor". The diagnosis has to be made with a biopsy before the surgical treatment. Healing is quickly obtained due to adjuvant treatments.
Bibliography:ObjectType-Case Study-2
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ISSN:1768-319X
DOI:10.1016/j.anplas.2015.09.001