• Archives of Plastic Surgery
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• v.34 no.4
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• pp.495-497
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• 2007

Purpose: Malignant peripheral nerve sheath tumors (MPNSTs) are rare neoplasms, usually arising from somatic soft tissues or peripheral nerves. Primary MPNST of the scalp is extremely rare. The case is being reported for its rarity. Methods: A 53-year-old female was presented with a scalp mass on vertex area. The tumor was localized in scalp skin and did not invade underlying periosteum or skull and treated with complete surgical excision followed by adjuvant chemotherapy and radiotherapy. Results: Histologically, the tumor showed malignant spindle cells with focal S-100 positivity on immunohistochemistry and a diagnosis of MPNST was made. Conclusion: Authors experienced a rare case of primary scalp MPNST and report the case.

• Archives of Plastic Surgery
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• v.36 no.1
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• pp.96-100
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• 2009

Purpose: Angiosarcoma of the scalp is unusual vascular tumor originating from endothelial cell. Angiosarcoma is an aggressive tumor with high propensity for both local recurrence and distant metastasis. We report 2 cases of angiosarcoma having poor prognosis recently. Methods: Case 1 was a 67 - year - old male patient. He visited the hospital with a $3{\times}5cm$ sized discolored mass in forehead. It began at one month ago from coming to the hospital. Case 2 was a 64 - year - old male patient. He visited for our hospital to remove a $4{\times}5cm$ sized scalp mass. He had a pruritis on scalp from 9 months ago before coming to the hospital. Despite of the conservative treatments, the wound was not healed and advanced necrotic lesion with hemorrhage. Results: Case 1 diagnosed as an angiosarcoma. He underwent a radical operation 5 times. But the tumor expanded multiple area in dura & frontal area of the brain. The patient rejected the treatment any more. And he died one month later. Case 2 diagnosed as an angiosarcoma and metastased to skull in MRI. He got a radical resection including cranium. Three months later, it recurred to ipsilateral Sternocleidomastoideus muscle. He got a additional operation & started radiotherapy. And now he is receiving chemotherapy, but the recurred lesion is expanding. Conclusion: Angiosarcoma is a highly malignant tumor. Especially it arises in vascularized area, it easily metastases. So it is the best to treat angiosarcoma with surgery included wide margins. Despite of the lesion is small, we remember that angiosarcoma is a tumor that consider to metastases.

• Archives of Craniofacial Surgery
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• v.18 no.3
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• pp.211-213
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• 2017

Eccrine spiradenoma is an uncommon benign adnexal tumor originating from the eccrine sweat gland. We diagnosed a eccrine spiradenoma on a 55-year-old man with histopathologic confirmation upon biopsy followed by complete resection, who had visited our clinic with a chief complain of occipital scalp mass. The solitary eccrine spiradenoma occurring in the scalp is rarely to be seen and should be considered as a differential diagnosis for a solitary cystic mass of the scalp.

• Archives of Plastic Surgery
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• v.36 no.3
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• pp.361-364
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• 2009

Purpose: Sebaceous carcinoma is a rare malignant tumor derived from the adnexal epithelium of sebaceous glands. This tumor usually occurs on the eyelids, but uncommonly it may occur on the extraocular sites. It is characterized by a tendency of local recurrence and occasional metastasis. Surgical excision is appropriate treatment for patients with sebaceous carcinoma. Because this kind of case is rare, we report two cases of sebaceous carcinoma developed on scalp. Methods: Case 1 was a 69 - year - old woman. She visited the hospital with a $1.5{\times}2.5cm$ sized reddish yellow - colored, slowly growing mass on left parietal scalp. The mass began at birth and started growing at 5 years ago. Case 2 was a 67 - year - old woman. She had $2.5{\times}3.0cm$ sized yellow - colored mass on right parietal scalp. It occured at birth and started growing at 3 years ago. And the masses had erythematous ulcer with sanguineous discharge. In the beginning, the masses were miliary nodule. Results: CT scan and fine needle biopsy were done. Case 1 and 2 were diagnosed as sebaceous carcinoma. Wide excision with safety margin of 10 mm and split thickness skin graft was done. Histological examination revealed well demarcated, irregular, variable sized tumor lobules. Each lobule was composed of sebaceous and undifferentiated cells. Postoperatively, the patients did well and the lesion had not recurred. Conclusion: Sebaceous carcinoma is an aggressive malignant tumor. It often can be mistaken for other skin tumors. Authors experienced two rare cases of sebaceous carcinoma developed on scalp. We recommend early wide excision with enough safety margin as treatment of sebaceous carcinoma.

• Archives of Plastic Surgery
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• v.36 no.4
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• pp.507-511
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• 2009

Purpose: Adenoid cystic carcinoma (ACC) is a rare malignant epithelial neoplasm derived from the salivary glands. In some cases, ACC may arise in other primary sites, such as skin. We report a case of adenoid cystic carcinoma arising the scalp skin of 69 - year - old woman. Methods: A 69 - year - old woman presented with a tender scalp nodule. A local wide excision was performed. Histopathologic examination was revealed the adenoid cystic carcinoma with basaloid cells in a cribriform pattern. The resection margins were free of tumor. Two years later a tumor recurred in the scarred area. The lesion was removed surgically and the histopathological diagnosis of adenoid cystic carcinoma was again established. After two years, tumor recurred again and diatant metastasis of the lung was diagnosed. A surgical wide excision was done and the close regular follow - up for recurrence was done. Two years later, third recurrence of the scalp was observed. We also performed the wide local excision with tumor free margin. Results: We experience the recurrent adenoid cystic carcinoma of the scalp with pulmonary metastasis. We have performed the wide local excision for three times. The patient has been followed up for 10 years with regular work - up for recurrence and metastasis Conclusion: primary cutaneous adenoid cystic carcinoma is a rare skin neoplasm with a high potential for recurrence after local excision. The standard treatment of ACC is wide local excision with tumor - free margins established by permanent section.

• Archives of Plastic Surgery
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• v.33 no.4
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• pp.491-494
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• 2006

Purpose: To report the case of recurred malignant proliferating trichilemmal tumor on scalp Methods: Case report and literature review Results: A 40-year-old man presented with a recurred malignant proliferating trichilemmal tumor, which developed on the occipital area. It was $8{\times}9{\times}4.5cm$ in size, protruded, firm and non-tender mass. This tumor was widely excised including normal skin margin and pericranium. Immediate reconstruction using free latissimus dorsi muscle flap and skin graft were done. Histopathologic examination revealed abrubt, compact trichilemmal keratinization in the central area of lobular epithelial proliferation. Conclusion: There has been no recurrence of tumor during follow-up period of nine months without adjuvant chemotherapy or radiotherapy.

• Journal of Korean Neurosurgical Society
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• v.58 no.4
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• pp.385-388
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• 2015

Low-grade myofibroblastic sarcoma (LGMS) is a rare sarcoma with myofibroblastic differentiation. LGMS has a propensity for local recurrence and is associated with a low risk of metastatic spread. A 26-year-old man presented with a 12-month history of a slow growing palpable hard mass in the right parietal scalp. Enhanced CT scan of head showed a $3{\times}4cm$ sized well-defined and heterogeneously enhancing scalp mass. The patient underwent excision of the tumor. The histological and immunohistochemical features were consistent with a LGMS. We performed re-operation for remnant tumor removal after diagnosis. After 14 months of surgery, the patient was well-being state.

• Annals of dermatology
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• v.30 no.6
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• pp.712-715
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• 2018

Desmoplastic fibroblastoma is a rare fibrous tumor that usually presents as a painless, slow-growing mass in the subcutaneous tissues and skeletal muscles. It has a wide anatomic distribution, with the most common involvement being the arm and shoulder. Here, we report a case of a tiny painful desmoplastic fibroblastoma arising on the scalp. According to a microscopic examination, this tumor was composed of spindle-shaped fibroblasts in the dense collagenous stroma. On immunohistochemical staining, tumor cells were positive for vimentin and negative for smooth muscle actin, CD34, and S100. Our case is unique in that desmoplastic fibroblastoma developed on the scalp and there was presence of pain despite its small size.

• Archives of Craniofacial Surgery
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• v.18 no.2
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• pp.112-116
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• 2017

The ideal scalp reconstruction involves closure of the defect with similar hair-bearing local tissue in a single step. Various reconstructions can be used including primary closure, secondary healing, skin grafts, local flaps, and microvascular tissue transfer. A 53-year-old female patient suffered glioblastoma, which had recurred for the second time. The neuro-surgeons performed radial debridement and an additional resection of the tumor, followed by reconstruction using a serratus anterior muscle flap with a split-thickness skin graft. Unfortunately, the flap became completely useless and a bilateral rotation flap was used to cover the defect. Two month later, seroma with infection was found due to recurrence of the tumor. Additional surgery was performed using multiple perforator based island flap. The patient was discharged two weeks after surgery without any complications, but two months later, the patient died. Radical surgical resection of tumor is the most important curative option, followed by functional and aesthetic reconstruction. We describe a patient with a highly malignant tumor that required multiple resections and subsequent reconstruction. Repeated recurrences of the tumor led to the failure of reconstruction and our strategy inevitably changed, from reconstruction to palliative treatment involving fast and stable wound closure for the patient's comfort.

• Investigative Magnetic Resonance Imaging
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• v.10 no.2
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• pp.121-125
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• 2006

A 48-year-old man presented with a dermatofibrosarcoma protuberans (DFSP) of the scalp associated with local recurrence. Axial T1- and T2-weighted images demonstrated a well-circumscribed hypointense and intermediate hyperintense mass in the skin and subcutaneous layer of the scalp, respectively. Contrast-enhanced T1-weighted images showed the strongly enhanced mass invasion to the skin, subcutaneous layer and adjacent galeal layer. Scalp DFSP is very uncommon but is an aggressive tumor, so MR imaging diagnosis of the extent of the lesion to underlying structures, and initial wide local resection is important to prevent recurrence.