RIGHT THIGH ANGIOSARCOMA RADICAL RESECTION AND FUNCTIONAL MUSCLE

RIGHT THIGH ANGIOSARCOMA - RADICAL RESECTION AND FUNCTIONAL MUSCLE TRANSFER: A CASE REPORT Jih-Sen Wong 1, Jiunn Tat Lee 1, Meng-Si Wu 2, Chien-Hsing Wang 2, Li-Fu Cheng 2, Chao-Chih Yang 2, Hon-Da Hsu 2 Division of Plastic Surgery, Department of Surgery, Buddhist Tzu Chi General Hospital, Hualien, Taiwan

Patient profile � Age: 28 � Gender: male � Past history: �Scald burn s/p(face, chest wall, four limbs, 2 nd degree, 35%) debridement + STSG 16 years ago � Chief complaint �Right thigh tumor for 4 years

Femur MRI T 1 FSE T 2 W Hypervascular nature and heterogenous enhanced pattern

T 1 FSE+C

Chest to pelvis CT

Whole body bone scan

Incisional biopsy � Well-differentiated angiosarcoma �Irregular anastomosing vascular channels dissecting through the collagen �Pleomorphic, hyperchromatic, and multilayering endothelial cells �Immunohistochemical stain �S-100 (-) �CD 31 (+) �CD 34 (-)

Wide excision and free ALT myocutaneous flap reconstrction

Pathology 1. Angiosarcoma, well-differentiated 2. 3. 4. 5. Size of Tumor: 3. 2 x 2. 0 x 1. 0 cm & 2. 5 x 2. 5 x 1. 5 cm Histologic Grade: I Primary Tumor: p. T 2 b Regional Lymph Nodes: p. N 0 Immunohistochemical stain: CD 31 (+) and CD 68 (+)

Post-operative radiotherapy 5940 c. Gy in 33 fractions

Post-operative follow up �No radiological sign of local recurrence or distant metastasis for 3 years �Functional outcome also improved that he can jog for 200 meters

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