Scalp Tissue Expansion Above a Custom-Made Hydroxyapatite Cranial Implant to Correct Sequelar Alopecia on a Transposition Flap

Abstract

Tissue expansion above hydroxyapatite implants may be of concern to the physician because of the risk of infection and rupture of the cranial implant. With this clinical case, we emphasize some precautions to prevent these issues.

Recurrent Dermatofibrosarcoma Protuberans of the Scalp Reconstructed by Visor Flap

“…Therefore wide excision is keystone of the successful treatment. [1,[3][4][5] Although DFSP of the head and neck constitutes less than 10% of cases, treatment of such entity is challenged by some anatomic and physiologic features. First, only limited amount of hair bearing scalp is available, which leads to an aesthetic problem in case of wide excision and skin grafting.…”

“…Alloplastic materials as well as biological glues may also be used for this purpose. [1] Bone grafts (from iliac crest or ribs), alloplastic materials (acrylic derivatives) or even autologous bone processed by autoclaving or irradiation can be employed to reconstruct defects of cranial [2,4] Small to average wounds can be closed by transposition of the rest of the scalp with primary closure or grafting of the donor site. However, repair of large scalp defects, which exceeding 9 cm in diameter, often require free tissue transfer.…”

“…Despite of locally aggressive behavior of classical dermatofibrosarcoma protuberans distant metastasis usually occurs only in 0.5% of cases and it most commonly affects the lungs. [1,7] Usual sites of occurrence include trunk and extremities and in only about 10% of cases DFSP occur in head and neck area. [1,2] Aberrations in 17 th and 22 nd chromosomes and previous local trauma are suggested to contribute to pathogenesis of DFSP.…”

“…[1,7] Usual sites of occurrence include trunk and extremities and in only about 10% of cases DFSP occur in head and neck area. [1,2] Aberrations in 17 th and 22 nd chromosomes and previous local trauma are suggested to contribute to pathogenesis of DFSP. [3] According to histological findings the tumor can be plaque, nodular, pigmented, fibrosarcomatous or juvenile type.…”

“…Immunohistochemistry reveals CD34 antigen and absence of S-100 marker, which is necessary for differentiation from other similar tumors. [1][2][3][4][5][6] Due to highly invasive nature DFSP can affect different underlying structures (fat tissue, fascia, muscle, bone, etc.) and cause various correspondent symptoms.…”