Chulalongkorn Medical Journal


The authors report a case of large malignant proliferating trichilemmal tumor of thescalp with calvarial destruction undergoing a successful staged operation to completelyexcise the tumor. The reconstruction of the scalp was delayed due to considerable amountof intraoperative blood loss and the negative pressure wound therapy was applied to thewound. The reconstruction with a free an anticoagulant thigh flap was subsequently performed5 days later. Five weeks postoperatively, the patient had transient visual impairment fromdural venous sinus thrombosis that was successfully treated with anticoagulation. On 1 yearfollow up, there was no evidence of tumor recurrence.



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