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Surgical Treatment of Cutaneous Angiosarcoma of Scalp：Usefulness of Preoperative Mapping Biopsies  

Kang, Min-Gu (Department of Plastic and Reconstructive Surgery, Seoul National University College of Medicine)
Park, Jong-Lim (Department of Plastic and Reconstructive Surgery, Seoul National University College of Medicine)
Kim, Myung-Good (Department of Plastic and Reconstructive Surgery, Seoul National University College of Medicine)
Minn, Kyung-Won (Department of Plastic and Reconstructive Surgery, Seoul National University College of Medicine)
Koh, Kyung-Suck (Department of Plastic Surgery, Asan Medical Center, University of Ulsan College of Medicine)
Chang, Hak (Department of Plastic and Reconstructive Surgery, Seoul National University College of Medicine)
Publication Information
Korean Journal of Head & Neck Oncology / v.23, no.1, 2007 , pp. 37-40 More about this Journal
Abstract
Objectives：Cutaneous angiosarcoma is an infrequent but aggressive neoplasm involving the skin of the face and scalp. Unfamiliarity with the clinical manifestations of cutaneous angiosarcoma frequently leads to misdiagnosis and delay in treatment. Complete surgical resection requires the performance of preoperative staging biopsies to determine the true extent of the neoplasm. Intraoperative frozen section analysis to determine the adequacy of the surgical resection is unreliable due to the high false negative rate. Material and Methods：In five scalp angiosarcoma cases, mapping biopsies were performed at far from the suspected edge of the neoplasm. On permanent pathology, we obtained tumor free margin with occasional focal involvement of the tumor. Results：Frozen-section analysis of the resected margins is inconclusive, for the subtle diagnostic features of angiosarcoma are distorted by the tissue processing required for frozen-section analysis. The characteristic dermal vessels lined by their malignant cells are collapsed by the freezing process. This results in a high rate of false-negative reports and possibly leads to incomplete resection of the neoplasm. Conclusion：Our recommendation is to establish the margins of the tumor by performing preoperative evaluations by mapping biopsies.
Keywords
Scalp angiosarcoma; Mapping biopsies; Resection margins;
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