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Submitted Case

2023
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12. Peer Review
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Patient Information: (Do not provide name of the patient)
Age
  85 (patient 1)/85 (patient 2)
Diagnosis
  angiosarcoma of scalp (patient 1)/undifferentiated pleomorphic sarcoma (malignant fibrous histiocytoma) of scalp (patient 2)
Imaging
  PET scan showed at least 3 new distinct areas of hypermetabolic nodular skin thickening in the left frontal and parietal scalp. (Patient 1)/PET scan showed an area of mildly increased activity at the frontal scalp/vertex, without a discrete CT correlate. (Patient 2)
Pathology
  High-grade angiosarcoma,, involving dermis and discontiguous (skip) foci abutting deep fascia. Tumor measured 1.3 cm in greatest dimension as a single nodule, but discontiguous tumor involved an area of at least 3.5 cm. Tumor involves the soft tissue and deep margins. A second lesion showed similar findings and measured 1.6 cm. (Patient 1)/undifferentiated pleomorphic sarcoma (malignant fibrous histiocytoma) involving full-thickness of skin, into the deep soft tissue below the adipose tissue, measuring 3.0 cm in greatest dimension
Overall Oncology Management Plan
Surgery (biopsy)
  Wide resection of 2 clinically apparent sites of disease on right side of scalp, with split-thickness skin graft placement. (patient 1)./Wide local excision of scalp lesion, with latissimus dorsi free flap reconstruction. (Patient 2)
Images
Session Name
  Head and Neck Specialist Dr. David Sher – August 28, 2023
Session ID
  13404
created_by
  7517
post_id
  13404
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