We present a patient with a primary intraosseous meningioma of the calvarium that recurred three years after initial resection and reconstruction with a free anterolateral thigh (ALT) flap. The patient re-presented wi...We present a patient with a primary intraosseous meningioma of the calvarium that recurred three years after initial resection and reconstruction with a free anterolateral thigh (ALT) flap. The patient re-presented with progressive swelling in the same area. Imaging confirmed aggressive tumour recurrence with both intra- and extra-cranial diseases and also extension to the ipsilateral orbit. The original anterolateral free flap was raised on anterior pedicle and further debulking of the tumour was performed. Histology confirmed widely infiltrative atypical meningioma (WHO grade II). This case highlights the benefit of using a fasciocutaneous free flap for reconstruction given the potential for tumour recurrence.展开更多
Background:Necrotising fasciitis(NF)is a rare but severe necrotising infection of the subcutaneous tissues.We report a case of periocular NF associated with a concurrent COVID-19 infection and explore potential mechan...Background:Necrotising fasciitis(NF)is a rare but severe necrotising infection of the subcutaneous tissues.We report a case of periocular NF associated with a concurrent COVID-19 infection and explore potential mechanisms of pathogenesis of COVID-19 infection and necrotising superinfections.Case Description:A 33-year-old previously healthy female presented with right-sided progressive periocular swelling,erythema,pain and fever,two days after sustaining a laceration to the right superolateral brow from a clenched fist.She had a concurrent COVID-19 infection,detected on nasopharyngeal polymerase chain reaction swab thirteen days prior to presentation and again at presentation.She did not have an oxygen requirement.There was a large bulbous collection of the right upper lid with fluctuance and overlying erythema,and a communicating sinus drained frank pus from the superolateral brow.Pre-operative T2-weighted MRI demonstrated fascial hyperintensity involving the pre-septal tissues and extending to the anterior temporal fossa.She was commenced on intravenous meropenem,clindamycin and vancomycin,and underwent early surgical debridement.Initial debridement demonstrated right upper lid necrosis involving the dermal and pre-septal layers,including the orbicularis,but sparing the tarsus.Streptococcus pyogenes was isolated,and she was continued on a prolonged course of intravenous antibiotic.Periocular defects were repaired with a right-sided brow adipo-fascial flap based on the supratrochlear artery,browpexy and dual full thickness skin grafts on the right upper lid and flap.Conclusions:NF is an acute fulminant infection rarely affecting the periocular tissues.This represents a unique case of periocular NF associated with a concurrent COVID-19 infection.展开更多
文摘We present a patient with a primary intraosseous meningioma of the calvarium that recurred three years after initial resection and reconstruction with a free anterolateral thigh (ALT) flap. The patient re-presented with progressive swelling in the same area. Imaging confirmed aggressive tumour recurrence with both intra- and extra-cranial diseases and also extension to the ipsilateral orbit. The original anterolateral free flap was raised on anterior pedicle and further debulking of the tumour was performed. Histology confirmed widely infiltrative atypical meningioma (WHO grade II). This case highlights the benefit of using a fasciocutaneous free flap for reconstruction given the potential for tumour recurrence.
文摘Background:Necrotising fasciitis(NF)is a rare but severe necrotising infection of the subcutaneous tissues.We report a case of periocular NF associated with a concurrent COVID-19 infection and explore potential mechanisms of pathogenesis of COVID-19 infection and necrotising superinfections.Case Description:A 33-year-old previously healthy female presented with right-sided progressive periocular swelling,erythema,pain and fever,two days after sustaining a laceration to the right superolateral brow from a clenched fist.She had a concurrent COVID-19 infection,detected on nasopharyngeal polymerase chain reaction swab thirteen days prior to presentation and again at presentation.She did not have an oxygen requirement.There was a large bulbous collection of the right upper lid with fluctuance and overlying erythema,and a communicating sinus drained frank pus from the superolateral brow.Pre-operative T2-weighted MRI demonstrated fascial hyperintensity involving the pre-septal tissues and extending to the anterior temporal fossa.She was commenced on intravenous meropenem,clindamycin and vancomycin,and underwent early surgical debridement.Initial debridement demonstrated right upper lid necrosis involving the dermal and pre-septal layers,including the orbicularis,but sparing the tarsus.Streptococcus pyogenes was isolated,and she was continued on a prolonged course of intravenous antibiotic.Periocular defects were repaired with a right-sided brow adipo-fascial flap based on the supratrochlear artery,browpexy and dual full thickness skin grafts on the right upper lid and flap.Conclusions:NF is an acute fulminant infection rarely affecting the periocular tissues.This represents a unique case of periocular NF associated with a concurrent COVID-19 infection.
