AB197. SOH25_AB_279. Scalp reconstruction after pleomorphic sarcoma resection: an analysis of Mullingar Regional Hospital’s inaugural major plastic surgery case
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AB197. SOH25_AB_279. Scalp reconstruction after pleomorphic sarcoma resection: an analysis of Mullingar Regional Hospital’s inaugural major plastic surgery case

Colum O’Reilly1, Kate Eustace1, Jose Varas2

1Department of Surgery, Regional Hospital Mullingar, Westmeath, Ireland; 2Plastics and Reconstructive Surgery Department, The Mater Misericordiae University Hospital, Dublin, Ireland

Background: Scalp tumour excision and reconstruction presents a unique set of surgical reconstructive challenges due to the functional and aesthetic importance of the region. Rare incidence, rapid development, and clinical and histopathological mimicry of other sarcomas pose further technical and diagnostic challenges in the diagnosis and management of pleomorphic sarcomas as seen in our case.

Methods: This case report outlines the presentation of a 69-year-old man referred from the Mater Hospital skin multidisciplinary team (MDT) in March 2024 for a rapidly growing occipital scalp sarcoma, confirmed on initial punch biopsies. He underwent wide local excision with transposition flap from left anterior thigh and split thickness skin graft one week later in Mullingar.

Results: This had a successful full-clearance surgical and aesthetic outcome that did not require adjuvant treatment in follow-up. Final histopathology and MDT review demonstrated a 29-mm pleomorphic sarcoma with 15-mm clear margins.

Conclusions: Historically, there has been very limited access to local and regional plastic surgery services for patients in the midlands area. The 2024 addition of a new plastic and reconstructive surgery clinic and service provision, minors list, and cases such as this one to Mullingar Regional Hospital seeks to broaden and expedite healthcare services to a wider patient population in rural Ireland. This case report analyses the surgical approach, differential diagnosis, outcomes and broader implications of Mullingar Hospital’s inaugural reconstructive plastic surgery case and a discussion on the difficult differential diagnosis between atypical fibroxanthoma and pleomorphic sarcoma and the importance of ongoing collaboration and input from MDT services in the Mater Hospital further strengthen ties with specialist centres for follow-up.

Keywords: Inaugural; Mullingar; new; rare; sarcoma

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Footnote

Funding: None.

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-25-ab197
Cite this abstract as: O’Reilly C, Eustace K, Varas J. AB197. SOH25_AB_279. Scalp reconstruction after pleomorphic sarcoma resection: an analysis of Mullingar Regional Hospital’s inaugural major plastic surgery case. Mesentery Peritoneum 2025;9:AB197.

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