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Esperienze Dermatologiche 2012 December;14(4):145-9


language: English, Italian

Sarcomas of the scalp: comparing two lesions

Ronco A. 1, Farnetti A. 1, Mattio R. 1, Deluca F. 1, Schiavone V. 1, Pochettino P. 2, De Paolis P. 3, Santoro L. 1, Pippione M. 3

1 Cutaneous Surgery and Oncology Department, Gradenigo Hospital, Turin, Italy; 2 S.C. Oncology, Gradenigo Hospital, Turin, Italy; 3 S.C. General Surgery, Gradenigo Hospital, Turin, Italy


We will describe two cases come under our observation of malignant fibrous histiocytoma and angiosarcoma. MFH is one of the most common soft tissue sarcoma of the head and neck. Local recurrence is frequent, lymph nodal metastasis are rare, but distant metastases can appear. The angiosarcomas occur at skin level or in soft superficial tissue: 50% of them appear in the head and neck region. A disease progression with local-regional involvement is frequent. Case 1. The first case refers to a patient with third MFH recurrence in the subcutaneous skull base region, treated with sole surgical therapy without any evidence of distant recurrence. The patient underwent a surgical treatment with wide excision of the lesion, until the bone surface, and reparation with skin transposition flap. After 6 weeks radiotherapy was conducted. Examined 3 years after, the patient presented neither recurrent lesions, nor distant metastasis. Case 2. The second case came under our observation with a recurrent lesion after surgical excision of skin angiosarcoma in the left frontoparietal region. After staging, where neither regional nor distant recurrences were remarked, surgical therapy with reparation by means of skin grafting was carried out. The histologic examination resulted in a superficial skin angiosarcoma G3 pT1a, with margins of surgical excision free from disease. Radiation therapy was carried out in the excision site. After 2 months 3 nodular lesions could be noted in the grafting site, after some days, other lesions appeared in the right and left parietal region. A systemic chemotherapy with Adriamycin was proposed. The pharmacological therapy was well tolerated, in spite of a disease progression until exitus. In compliance with the literature, MFH is one of the most common soft tissue sarcomas of the head and neck region. The local recurrence is frequent, but it is possible to obtain a good outcome after adjuvant therapy. The skin angiosarcoma, on the contrary, maintains a high-grade aggressiveness, even after adjuvant therapeutic treatment.

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