Evolution of the free groin flap: the superficial circumflex iliac artery perforator flap.

BACKGROUND: The free groin flap, revolutionary in 1972, has gradually lost its relative popularity because of the new free flaps available as well as because of some of its inherent disadvantages, including a short arterial pedicle, variable arterial anatomy, the generally small caliber of the included blood vessels, its bulkiness, and numbness at the donor site. METHODS: From December of 2002 to May of 2004, the authors successfully overcame a number of these disadvantages by means of clinical application of the superficial circumflex iliac artery perforator flap in 12 patients (age range, 15 to 67 years). These surgical procedures involved nine recipient sites in the upper limbs, two in the foot, and one in the buccal region. RESULTS: This flap not only overcomes most of the disadvantages of the free groin flap but also demonstrates many of its advantages, including the following: (1) concealment of the donor-site scar; (2) primary closure of the donor site; (3) the availability of a large cutaneous flap (25 x 8 cm to 6 x 4 cm); (4) non-hair-bearing skin; (5) longer arterial pedicle (3 to 13 cm); (6) typically requiring no vessel grafting; (7) seldom being a "bulgy" flap; (8) smaller are of numbness at the donor site; and (9) less time required for flap dissection (0.5 to 1.5 hours). CONCLUSIONS: The superficial circumflex iliac artery perforator flap is an evolution of the conventional free groin flap. This flap not only overcomes most of the disadvantages of the free groin flap but also offers the many advantages of the successful application of the free groin flap.

MRI of epithelioid sarcoma of the thigh.

A 31-year-old woman with epithelioid sarcoma of the thigh is presented. The patient had had a progressively growing mass in her left thigh for 4 months. Magnetic resonance imaging (MRI) showed a subcutaneous mass with a central area of hypointensity and serpiginous hyperintensity in the peripheral portion. Such findings have not been reported before. Histologic findings were compatible with epithelioid sarcoma.

Malignant transformation of an ovarian mature cystic teratoma: computed tomography findings.

INTRODUCTION: The malignant transformation of an ovarian mature cystic teratoma is rare. We presented such a case of a 46-year-old woman with characteristic computed tomography (CT) findings. CASE REPORT: The patient had suffered from fullness and tenderness of the lower abdomen for one year. A high serum CA-125 level was noted. Computed tomography images showed a left adnexal mass with fat, calcification and soft tissue components, and areas of invasion through the teratoma wall. OUTCOME: The histologic diagnosis was compatible with a squamous cell carcinoma arising from a mature cystic teratoma of the ovary.

MRI of hemangiopericytoma in the sacrum.

Osseous hemangiopericytoma is rare. We present a case of a 30-year-old woman with low-back pain with radiation to the left buttock for 1 month. Magnetic resonance imaging (MRI) showed a tumor mass with areas of serpentine signal void pattern in the sacrum suggestive of a vascular tumor. Neither calcifications nor layered blood serum were noted. Histological diagnosis was compatible with osseous hemangiopericytoma.