Serial Reconstruction Considerating the Aesthetic Unit on Congenital Giant Nevus in Periorbital Area

PURPOSE: Soft tissue deformity and skin defect after tumor resection in the periorbital area can cause trouble in the function of eyelid as well as in the aspect of external appearance. Therefore, as cosidering reconstruction in periorbital area, detailed assessment of both functional and aesthetic property are required. thus, the purpose of this study is to examine an appropriate reconstruction through clinical cases. METHODS: A 14-year-old girl with congenital giant hairy nevus on right periorbital area was selected. Her first visit to our plastic surgery outpatient clinic was on July 2006. Since then, she has undergone staged removal of lesions and reconstruction by various flap technique such as pedicled island flap, forehead galeal flap, paramedian forehead flap, cheek rotation & advancement flap. RESULTS: In the case of this girl, most lesions were removed and replaced by normal skins. Although there was the difference of skin color after skin graft, such difference was not noticeable and section scar by skin flaps was slight. There was no obvious dysfunction in the eyelids and the girl and her parents were satisfied with results after the surgery. CONCLUSION: In the reconstruction of soft tissue defect or soft tissue deformity and contracture, it is required to choose appropriate reconstruction method, considering aesthetic and functional aspects depending on aesthetic unit sufficiently.

A Case Report of Giant Cell Tumor of the Occipital Bone

PURPOSE: Giant cell tumors of the bone are rare, locally aggressive lesions that primarily affect the epiphysis of the long bones in young adults. These tumors occur very rarely on the skull, principally in the sphenoid and temporal bones. The occipital bone is an unusual site. We report a rare case of a giant cell tumor of the occipital bone with a review of the relevant literature. METHODS: A 7-year-old boy presented with a mass of the right occipital area, which was accompanied by localized tenderness and mild swelling. The mass was first recognized approximately 1 year earlier and grew slowly. There was no significant history of trauma. The physical examination revealed a non-mobile and non-tender bony swelling on the occipital region. The neurological evaluation was normal. The serial skull radiography and CT scan showed focal osteolytic bone destruction with a bulged soft tissue mass in the right occipital bone. The patient underwent a suboccipital craniectomy and a complete resection of the epidural mass. The lesion was firm and cystic. The mass adhered firmly to the dura mater. RESULTS: The postoperative clinical course was uneventful, and the patient was discharged 5 days later. The histopathology report revealed scattered multinucleated giant cells and mononuclear stromal cells at the tumor section, and the giant cells were distributed evenly in the specimen, indicating a giant cell tumor. CONCLUSION: Giant cell tumors are generally benign, locally aggressive lesions. In our case, the lesion was resected completely but a persistent long term follow up will be needed because of the high recurrence rate and the possible transformation to a malignancy.