Objective. We describe specific surgical methods for angiosarcoma regarding extent of resection and reconstructive options and assess their effect on patients' prognosis. Patients and Methods. We retrospectively examined 14 patients undergoing treatment for angiosarcoma of the scalp at our institute between January 2000 and June 2015. Surgical treatment comprised wide excision of the tumor and reconstruction using a free flap with skin graft. Kaplan-Meier survival analysis was used to assess the survival parameters. Univariate and multivariate analyses were performed to evaluate the association between risk factors and outcome parameters. Results. Mean patient age at diagnosis was 69 years, and the mean follow-up period was 17 months. The overall 5- and 2-year survival rates were 15% and 75%, respectively, whereas the 5- and 2-year disease-free survival rates were 7.7% and 38.7%, respectively. The mean survival duration was 32 months. Metastatic tumor dissemination to the lung or brain was closely associated with the major cause of death. Only a deep excision margin was significantly related to the recurrence rate. Conclusions. Cases of angiosarcoma had a poor prognosis despite the aggressive treatments. Sufficient resection margins are essential for controlling local recurrence. The effect of multidisciplinary approaches needs to be explored.

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Subungual masses accompanying nail deformity are of common occurrence and uniquely confirmed by histopathologic examination postoperatively. Although glomus tumor is most frequently diagnosed with its specific clinical triad, other rarer diagnoses have also been reported. Though ganglion cysts are predominantly found around the distal phalangeal joint as a mucous cyst and myxoid cyst, they might also appear as a subungual mass accompanied by nail deformity thereby mimicking the glomus tumor. A 54-year-old woman visited our outpatient clinic with nail deformity and pain on the tip of the right thumb. She had a history of nail root injury on her right thumb which occurred 3 months back at a nail shop. Physical examination revealed a convex point with tenderness on the right thumbnail. Doppler ultrasonography revealed the presence of 0.43×0.26×0.53 cm3 sized non-specific cystic lesion with hypoechogenicity and no abnormal vascularity. Complete excision of the cyst was performed and histopathology revealed a ganglion cyst. Subungual ganglion cyst is rarely occurred and known to be usually asymptomatic. Herein, we report a case of ganglion cyst of subungual area which was mistakenly diagnosed as a glomus tumor preoperatively.

Our anatomic and angiographic studies in this clinical series indicate that the EJ-VAF flap is a reliable and convenient flap. Thus, it is useful in reconstruction of small to medium head and neck defects.