Poland syndrome and breast tumor: a case report and review of the literature

Poland syndrome is a rare congenital malformation. Hypoplasia of the sternocostal portion of the pectoralis major muscle is the most significant feature and is most frequently associated with homolateral breast hypoplasia. In this article, the authors present a case of bilateral phyllodes tumors in a 28-year-old woman with Poland syndrome and discuss (1) the relationship between the condition and breast cancer, (2) the modes of surveillance in patients with Poland syndrome, and (3) its impact on breast reconstruction.

[Retrospective study of third degree cervico-facial burns]

INTRODUCTION

Cervical and facial burns can be responsible of social and professional exclusions, functional limitations and psychological repercussions. Composite allotransplantation has become a reality for complex facial reconstructions. The purpose of this study is to evaluate the sequelae of third degree facial burns that might fit into a facial transplant program.

PATIENTS AND METHODS

We conducted a retrospective study in our burn unit from May 2006 to July 2009. We included all the patients with third degree cervico-facial burns. One hundred and eighty seven patients were selected. We excluded 87 patients for insufficient initial photography or lack in the medical data. The topography of the facial burns was analysed for each patient and separated into different aesthetic sub units. A questionnaire was mailed to the patients evaluating the psychological, functional and aesthetic sequelae.

RESULTS

The follow-up was of 12 months at least. Of the 100 patients, 82 presented with partial facial burns and 18 with full facial burns. Of the 82 patients with partial burns, 48% had burns in the chin area, 45% in the neck area, 41% in the cheeks and 37% in the ears. The sub units associated with functional sequelae were the neck (32%) and the peri-buccal and peri-orbital region (11-14%). On the 100 questionnaires, 28 patients responded.

CONCLUSION

Third degree burns sequelae concerned mainly the neck and the lower third of the face. The indication of facial allotransplantation remains rare in the burn patient. The deep carbonisation and the very extensive burn patient with severe functional sequelae where the standard reconstructive procedures are inefficient might be eligible for a facial allotransplant program.

Breast reconstruction in Poland anomaly with endoscopically-assisted latissimus dorsi muscle flap and autologous fat tissue transfer: a case report and review of the literature

OBJECTIVE

The breast deformity in females with Poland anomaly (Poland syndrome) can be particularly embarrassing from esthetic and social point of view. Various methods of breast reconstruction were reported comprising breast implants, latissimus dorsi (LD) flap or the combination of these two. The aim of this study was to present a breast reconstruction in Poland anomaly with endoscopically-assisted LD muscle flap in association with autologous fat tissue transfer and to analyse the results in the light of the literature data.

PATIENTS AND METHODS

An 18-year-old woman presented with severe left breast hypoplasia (in the context of a Poland anomaly) with heavy social and psychological impact on both private and professional life. No thoracic deformity was clinically and radiologically detectable. The preoperative imaging studies of the breast (mammography and ultrasound) did not show any pathological findings. A three-stage autologous breast reconstruction was performed. An endoscopically assisted LD muscle flap was carried out during the first stage. This was followed by two stages of autologous fat tissue transfer and reduction mammaplasty of the opposite breast.

RESULTS

No postoperative complications were observed. The postoperative pain was less intensive than in the classic open technique. The LD muscle harvesting was carried out through a smaller incision which left a smaller back scar. The final result was breast symmetry of excellent quality.

CONCLUSIONS

The breast reconstruction in Poland anomaly can be performed with entirely autologous techniques. Endoscopic techniques in LD harvesting leave smaller scars and cause less postoperative pain. The autologous fat tissue transfer can be an useful adjunct to the classic flap techniques provided that safety requirements in technique and follow up are strictly observed.

[The nasolabial flap and the buccinator flap. Anatomic study and 2 cases reports]

The authors present an anatomical study of the nasolabial flap and buccinator flap on 12 cadavers. This study was illustrated by 2 clinical cases: a case of reconstruction of the philtrum with a superiorly based nasolabial flap and a case of reconstruction combining an inferiorly based nasolabial flap and an ipsilateral anteriorly based musculomucosal buccinator flap.