ABSTRACT
Breast reconstruction is recognized as an integrated part of breast cancer treatment today. Depending on tumor characteristics, different types of partial and total breast resections are indicated: tumorectomy, nipple/skin sparing or complete mastectomy. Patients' desires, general health status and body shape, as well as the necessity of adjuvant therapies, lead to the individual reconstruction plan. Next to implant-based reconstructions, autologous reconstructions play a great role, including local, pedicled and free flaps as well as autologous fat grafting. In cases of tumorectomy, oncoplastic surgery comes into play: it is the combination of a large tumor resection and immediate breast reconstruction with the remaining breast tissue.
À l'heure actuelle, la reconstruction mammaire est reconnue comme partie intégrante du traitement du cancer du sein. En fonction des caractéristiques tumorales, différents types de résections mammaires sont indiqués : tumorectomie, mastectomie avec épargne du mamelon ou de la peau, ou mastectomie totale. L'état de santé général, la nécessité de thérapies adjuvantes, la morphologie et les souhaits des patientes déterminent le plan de reconstruction. En plus de la reconstruction à base d'implants, celle par lambeaux autologues (lambeaux locaux, pédiculés ou libres), ainsi que le transfert de graisse autologue jouent un rôle important. En cas de tumorectomie, la chirurgie oncoplastique entre en jeu, soit la combinaison d'une résection tumorale importante et d'une reconstruction mammaire immédiate par remaniement de la glande persistante.
Subject(s)
Breast Neoplasms , Mammaplasty , Humans , Female , Mastectomy , Breast Neoplasms/surgery , Goals , AutograftsABSTRACT
ABSTRACT: Brooke-Spiegler Syndrome (BSS) is a very rare autosomal dominant hereditary disease which arises from heterozygous mutations in the CYLD gene. Patients with BSS are predisposed to multiple skin appendage tumors such as cylindromas, which are benign tumors occurring mainly on the scalp. The tumors mostly appear around puberty and usually show slow growth throughout life. Malignant cylindroma formation in BSS patients has been reported. Apart from the skin, major and minor salivary glands have rarely been involved.We here report a case of a 46-year-old female patient with BSS presenting with multiple aesthetically and functionally unpleasing cylindromas covering almost her entire hair-bearing scalp with further tumors on her face. Interestingly, her parotid glands were enlarged and showed multiple lesions with a diameter up to 18 to 20âmm. She was successfully treated by total subgaleal scalp excision and coverage through a dermal substitute and split thickness skin graft. Constant follow-up imaging was initiated to prevent unhindered tumor growth of salivary glands.
