Surgical treatment of angiosarcoma of the scalp with superficial parotidectomy

Angiosarcomas of the scalp area are rare tumors mostly affecting elderly patients. In many series, potential treatment options for patients with scalp angiosarcoma have included surgery, radiation, and chemotherapy. Surgery combined with radiation therapy, however, did not appear to cure many patients. For these reasons, there is a serious need for the development of new approaches. We report our experience of 8 patients presenting angiosarcoma solely of the scalp. Our procedure consisted in radical tumor resection or the scalp with minimal 5-cm safety margins from the most peripheral scatted lesions with burring of the external table of the cranium, ipsilateral superficial parotidectomy, and ipsilateral upper neck dissection. After resection of the tumor of the scalp, the latissimus dorsi free flap was used for coverage of the defect. With prophylactic dissection of these regional lymph nodes, we could achieve better results and, at least, prolonged time to local recurrence and distant metastasis.