PMC1314891_01
63 year old male patient presenting with a large 8 x 8 cm measuring exulcerated suppurating tumor of the scalp (Marjolin's ulcer).
1471-2407-5-150-1.jpg
PMC1314891_01_1471-2407-5-150-1.jpg
F1
A 63 year old male patient presented with a large 8 x 8 cm ulcerated and suppurating tumour of the scalp (Fig. 1).
Nuclear magnetic resonance imaging revealing tumor infiltration of the cranium and frontal cortex.
1471-2407-5-150-2.jpg
PMC1314891_01_1471-2407-5-150-2.jpg
F2
Nuclear magnetic resonance and computed tomography imaging revealed a tumour with infiltration of the cranium and the brain (Fig. 2).
Four weeks postoperative aspect of donor site at left forearm.
1471-2407-5-150-3.jpg
PMC1314891_01_1471-2407-5-150-3.jpg
F3
The donor site was covered with a split thickness skin graft from the thigh (Fig. 3).
Uncomplicated healing of radial forearm flap on left hemicranium.
1471-2407-5-150-4.jpg
PMC1314891_01_1471-2407-5-150-4.jpg
F4
Postoperative healing was uneventful and the patient regained his speech immediately after the operation (Fig. 4).
Six weeks after primary resection tumor relapse with multiple satellite metastases around the radial forearm flap.
1471-2407-5-150-5.jpg
PMC1314891_01_1471-2407-5-150-5.jpg
F5
Six weeks later, the patient was referred to our unit again with multiple satellite nodules around the radial forearm free flap (Fig. 5).
Secondary wide resection and closure of defect with a skin grafted latissimus dorsi myocutaneous flap consecutively connected to the former radial artery and vein of the primary flap.
1471-2407-5-150-6.jpg
PMC1314891_01_1471-2407-5-150-6.jpg
F6
After the second operation postoperative healing was uneventful again, and the patient recovered well initially for the first three weeks (Fig. 6 and 7).
Uneventful early postoperative course after second free flap with uncomplicated donor site and no impairment of shoulder function.
1471-2407-5-150-7.jpg
PMC1314891_01_1471-2407-5-150-7.jpg
F7
After the second operation postoperative healing was uneventful again, and the patient recovered well initially for the first three weeks (Fig. 6 and 7).