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Reconstruction of a pediatric malignant peripheral nerve sheath tumor with a free osteocutaneous fibula flap: a case report

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Abstract

Malignant peripheral nerve sheath tumor (MPNST) is an extremely rare and biologically aggressive tumor. Treatment should ensure wide resection with negative margins because of the high recurrence rate and the risk of metastatic spread as well as the limited benefit of chemotherapy in children. Vascularized bone free flaps are considered the gold standard in reconstructing congenital, infectious, trauma or tumor induced significant defects in the mandible. Optimal reconstruction of mandibular defects is controversial. Simplicity of tecnique with minimal donor site morbidity is a important requirement of a well reconstruction. Important factors such as facial aesthetics and chewing should be taken into account in the planning of pediatric head and neck reconstruction. This study aims to present a MPNST in the left mandible and the mandible’s reconstruction with a free vascularized osteocutaneous fibula flap in a 5-year-old patient. There was not any complication in the 3-year follow-up. Mandibular growth and facial symmetry were maintained.

Level of evidence: Level V, therapeutic study.

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Authors and Affiliations

  1. Department of Plastic, Reconstructive and Aesthetic Surgery, Sisli Hamidiye Etfal Training and Research Hospital, University of Health Sciences, Istanbul, Turkey

    Soysal Bas & Sabri Ozturk

  2. Department of Radiation Oncology, Istanbul University Oncology Institute, Istanbul, Turkey

    Ayca Iribas Celik

  3. Department of Pediatric Oncology and Hematology, Sisli Hamidiye Etfal Training and Research Hospital, University of Health Sciences, Istanbul, Turkey

    Dildar Bahar Genc

  4. Department of Pathology, Sisli Hamidiye Etfal Training and Research Hospital, University of Health Sciences, Istanbul, Turkey

    Fevziye Kabukcuoglu

Authors
  1. Soysal Bas
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  2. Sabri Ozturk
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  3. Ayca Iribas Celik
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  4. Dildar Bahar Genc
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  5. Fevziye Kabukcuoglu
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Corresponding author

Correspondence to Sabri Ozturk.

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Conflict of interest

Soysal Bas, Sabri Ozturk, Ayca Iribas Celik, Dildar Bahar Genc, and Fevziye Kabukcuoglu declare no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. For case reports, formal consent from our hospital ethics committee is not required.

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Informed consent was obtained from the parent of the pediatric patient included in this study.

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The parent signed patient consent regarding publishing pediatric patient’s data and photographs.

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Bas, S., Ozturk, S., Celik, A.I. et al. Reconstruction of a pediatric malignant peripheral nerve sheath tumor with a free osteocutaneous fibula flap: a case report. Eur J Plast Surg 45, 1021–1026 (2022). https://doi.org/10.1007/s00238-022-01976-9

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  • DOI: https://doi.org/10.1007/s00238-022-01976-9

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