Dados do Trabalho

Título

RECONSTRUÇAO DA PAREDE TORACICA COM EPIPLOO E RETALHO DERMO-CUTANEO INFERIOR ABDOMINAL EM ANGIOSARCOMA MAMARIO - RELATO DE CASO

Título em Inglês

RECONSTRUCTION OF THE THORACIC WALL WITH THE EPIPLOON AND DERMO-CUT ABDOMINAL LOWER NEO FLAP IN BREAST ANGIOSARCOMA - CASE REPORT

Introdução

Breast angiosarcoma is very rare and highly aggressive. It has an incidence of 0.5 to 1% of cases and its presentation is typically in women between 14 and 82 years of age with an average age that revolves around 35 years of age. Breast angiosarcoma presents clinically as a unilateral, softened tumor with ill-defined borders and skin thickening, with a variable growth rate, however, if compared to epithelial breast cancer, angiosarcoma has a faster growth rate. The second is known as stromal sarcomas, fibrosarcomas, leiomyosarcomas, Histiocytomas, and giant cell sarcoma. Regarding adjuvant therapy, chemotherapy and radiotherapy, it presents an ineffective response. The effective treatment to offer a chance of healing is a broad surgical approach.

Relato de caso

Patient U.S,35, female, from Paulo Afonso-PE, complaining of breast nodule E. had surgery in his city, tumorectomy, resulting from fibroadenoma and phyloid tumors with atypia and mitosis. In our service, she underwent a battery of tests, where mg/usg confirmed the presence of a 1.5 cm nodule in breast E.She underwent a new segmental resection surgery, whose histopathology confirmed a low-grade malignant cystosarcoma filoid and exiguas margins.A new surgical proposal was discussed with the patient,simple mastectomy with immediate reconstruction with silicone implant and latissimus dorsi flap.The surgery was performed and the histopathological result was the absence of residual neoplastic tissue, with area of scar fibrosis and hyperplasia typical ductal. After her recovery, the patient was referred to clinical oncology and radiotherapy, but both had no indication for adjuvant therapy.
After 1 year, the patient returned to perform symmetrization of the opposite breast and reconstruction of the nipple-areolar complex. After 2 years, the patient returned with breast US, which demonstrated a nodular image of 1.5 cm adjacent to the breast prosthesis and MRI suggested the same image. A core biopsy was performed, which confirmed a malignant variant recurrent tumor. The tumor evolved very quickly (Fig 1) and the surgery was performed with an enlarged resection of the entire pectoralis large and small and skin inclusion (Fig 2). To correct the deformity, we used the rotation of the great epiploon with the lower abdominal dermocutaneous flap.

Palavras Chave

Angiosarcoma; dermo-cut; reconstruction.

Área

TREATMENT - Surgery and Reconstruction