Two cases of pediatric epithelioid sarcoma of the hand and coverage with Integra®

Mihaela Năstasă, Vincent Casoli

Abstract


Epithelioid sarcoma is an uncommon soft tissue tumor of the hand characterized by high frequency misdiagnosis and high potential for local recurrence and regional lymph node metastasis. The recommended treatment is wide excision, which leaves complex tissue defects with tendon or neurovascular structure exposure requiring coverage. We present two patients who had tumor excision followed by wound coverage with dermal regeneration template and split-thickness skin graft. Integra® template represents a different approach, which provides a safe, reliable and effective means of soft tissue coverage of the hand.


Keywords


epithelioid sarcoma; pediatric; wide excision; Integra; reconstruction

Full Text:

PDF

References


Talbot SG, Mehrara BJ, Disa JJ, et al. Soft-tissue coverage of the hand following sarcoma resection. Plast Reconstr Surg 2008; 121(2):534-543.

Chase DR, Enzinger FM. Epithelioid sarcoma. Diagnosis, prognostic indicators and treatment. Am J Surg Pathol 1985; 9(4):241-263.

Enzinger FM. Epithelioid sarcoma. A sarcoma simulating a granuloma or a carcinoma. Cancer 1970; 26(5):1029-1041.

Fisher C. Epithelioid sarcoma of Enzinger. Adv Anat Pathol 2006; 13(3):114-121.

Gustafson P, Arner M. Soft tissue sarcoma of the upper extremity: descriptive data and outcome in a population-based series of 108 adult patients. J Hand Surg Am 1999; 24(4):668-674.

McPhee M, McGrath BE, Zhang P, Driscoll D, Gibbs J, Peimer C. Soft tissue sarcoma of the hand. J Hand Surg Am 1999; 24(5):1001-1007.

Muramatsu K, Ihara K, Doi K, Hashimoto T, Taguchi T. Sarcoma in the forearm and hand: clinical outcomes and microsurgical reconstruction for limb salvage. Ann Plast Surg 2009; 62(1):28-33.

Brien EW, Terek RM, Geer RJ, Caldwell G, Brennan MF, Healey JH. Treatment of soft-tissue sarcomas of the hand. J Bone Joint Surg Am 1995; 77(4):564-571.

Kawai A, Hasizume H, Sugihara S, Morimoto Y, Inoue H. Treatment of bone and soft tissue sarcomas of the hand and wrist. Int Orthop 2002; 26(1):26-30.

Sobanko JF, Dagum AB, Davis IC, Kriegel DA. Soft tissue tumors of the hand. 2. Malignant. Dermatol Surg 2007; 33(7):771-785.

Gross E, Rao BN, Pappo AS, et al. Soft tissue sarcoma of the hand in children: clinical outcome and management. J Pediatr Surg 1997; 32(5):698-702.

Burgos AM, Chávez JG, Sánchez JL, Sánchez NP. Epithelioid sarcoma: a diagnostic and surgical challenge. Dermatol Surg 2009; 35(4):687-691.

Green D, Hotchkiss R, Pederson W, Wolf S. Green's Operative Hand Surgery, 5th Edition. Philadelphia: Churchill, 2005.

Güngör E, Aköz T, Karakayali G, Artüz F, Erdoğan B, Alli N. Epithelioid sarcoma: a confusing rare tumor on the hand. Plast Reconstr Surg 1998; 102(3):925-926.

Pai KK, Pai SB, Sripathi H; Pranab, Rao P. Epithelioid sarcoma: a diagnostic challenge. Indian J Dermatol Venereol Leprol 2006; 72(6):446-448.

Prat J, Woodruff JM, Marcove RC. Epithelioid sarcoma. An analysis of 22 cases indicating the prognostic significance of the vascular invasion and regional lymph node metastasis. Cancer 41(4):1472-1487.

Mathes SJ, Rod Hentz V. Plastic Surgery, 2nd Edition.Philadelphia: Saunders, 2005.

Throne CH, Bartlett SP, Beasley RW, Aston SJ, Gurtner GC, Spear SL. Grabb and Smith's Plastic Surgery, 6th Edition. Philadelphia: Lippincott Williams & Wilkins, 2007.

Owens JC, Shiu MH, Smith R, Hajdu SI. Soft tissue sarcomas of the hand and foot. Cancer. 1985; 55(9):2010-2018.

Gürkan V, Ozger H. Sarcomas of the hand. Acta Orthop Traumatol Turc 2007; 41(4):286-290.

Pradhan A, Cheung YC, Grimer RJ, et al. Soft-tissue sarcomas of the hand: oncological outcome and prognostic factors. J Bone Joint Surg Br 2008; 90(2):209-214.

Osaka S, Hoshi M, Sano S, Nozaki M, Yamamoto M. Description of new composite tissue transfer for salvage of a complex hand defect. Clin Orthop Relat Res 1996; (328):91-93.

Lin PP, Guzel VB, Pisters PW, et al. Surgical management of soft tissue sarcomas of the hand and foot. Cancer 2002; 95(4):852-861.

Carothers JT, Brigman BE, Lawson RD, Rizzo M. Stacking of a dermal regeneration template for reconstruction of a soft-tissue defect after tumor excision from the palm of the hand: a case report. J Hand Surg Am 2005; 30(6):1322-1326.

Integra® dermal regeneration template. Information for Patients and their Families [https://www.accessdata.fda.gov/cdrh_docs/pdf/P900033S008d.pdf available at 09.23.2018].




DOI: http://dx.doi.org/10.22551/2018.20.0503.10131

Copyright (c) 2018 Mihaela Năstasă, Vincent Casoli

Creative Commons License
Archive of Clinical Cases is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

 

ISSN: 2360-6975