Summary:
Epithelioid sarcoma is a rare, high-grade malignant soft tissue tumor that is often misdiagnosed. Classified as a mesenchymal malignancy, it exhibits both mesenchymal and epithelial markers. Occurrence in children under age 10 is extremely rare. This report describes the clinical course and management of a 5-year-old girl who presented with epithelioid sarcoma in the distal extremity. The lesion was initially misdiagnosed and treated for over a year as a common wart.
Summary:
Radiation therapy following oncologic resection can result in incisional breakdown, delay or cessation of wound healing, and exposure of structures. Impaired wound healing often mandates free tissue transfer for definitive closure and preservation of function. We present the case of a 16-year-old male patient who had a major incisional dehiscence following resection of a synovial sarcoma of the lower leg after postoperative irradiation. The progressive wound breakdown failed to respond to local wound care or negative pressure therapy and progressed to expose tendons of the distal leg. The patient was successfully treated with SkinTE, an autologous homologous skin graft and casting. Healing was slow but the wound filled with granulation tissue (which covered the tendon), epithelialized, and led to an excellent cosmetic and functional result. This highlights the potential of stem cell therapy and other forms of regenerative methods in healing of complicated wounds.
Heminasal aplasia is a rare congenital nasal anomaly in which there is unilateral deficiency in both the external nasal anatomy and nasal airway. Unilateral failure in development of a nasal placode in embryogenesis is thought to be the underlying cause of this anomaly. The authors describe the reconstruction of heminasal aplasia in a teenager utilizing a templated cartilaginous framework and tissue expansion. The authors feel the satisfactory results of this technique will be of benefit to other surgeons who may encounter this rare anomaly.
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