Radiation Ulcer in the Epigastric Region: A Rare Case

• Main Authors: Xu Shuqia, Zhu Zhaowei, Xu Yangbin, Liu Xiangxia
• Format: Article
• Language: English
• Published: JCDR Research and Publications Pvt. Ltd. 2020-10-01
• Series: International Journal of Anatomy Radiology and Surgery
• Subjects: abdominal wall; pedicled flaps; perforator flap
• Online Access: http://www.ijars.net/articles/PDF/2563/44404_CE[Ra1]_F(SHU)_PF1(AG_SHU)_PFANC(SHU)_PN(SHU)_PF2(AvG_OM).pdf
• ISSN: 2277-8543; 2455-6874

Radiation Therapy (RT) constitutes an integral part of oncological treatment. Skin changes following RT can range from dermatitis to non-healing ulcer. The advances in delivery of radiation like Intensity Modulated Radiotherapy (IMRT) and its further developments have reduced the incidence of these complications. However, patients who had received RT much earlier before the era of IMRT can manifest these complications many years later. Hereby, Authors report a 66-year-old male who presented with an ulcer in the epigastric region, which was not healing for more than 10 years. Patient had Dermatofibrosarcoma Protuberans (DFSP) resection at that area followed by radiation 20 years ago. The ulcerative skin was resected and covered with oblique paraumbilical perforator flap. The histopathology examination done on excised specimen was confirmed as radiation related skin ulcer and was negative for tumour cells. Oblique paraumbilical perforator flap is ideally suited for coverage of epigastric region as done in present case. It has multiple advantages such as good matching skin quality and texture, reliable blood supply and primary closure of the donor site.