Skip to main content

Advertisement

SpringerLink
Log in

Case report: chronic inflammatory ulcer and osteoradionecrosis of the skull following radiotherapy in early childhood

  • Case Report
  • Published:
Oral and Maxillofacial Surgery Aims and scope Submit manuscript

Abstract

Introduction

Chronic inflammatory diseases of the skin are the most common differential diagnosis of tumorous lesions of the craniofacial region. Detailed information about a patient's medical history is important for the clinical diagnosis of such cases. Previous radiotherapy should be taken into account, especially in cases of chronic dermatitis, since complications include osteoradionecrois of the adjacent bone strucutres with surrounding inflammation.

Case Report

We present the case of a 77-year-old femal patient who was admitted to our department with a slightly progressive ulcerating lesion of the frontotemporal skull. The patient had received radiotherapy in early childhood as primary therapy for hemangioma. Diagnostic imaging and biopsies revealed a diagnosis of chronic ulceration with underlying osteonecrosis and fibrotic osteomyelitis of the skull. A complex reconstruction of osseous structures and soft tissue was necessary to resolve her complaints.

Conclusion

Chronic radiodermatitis and osteoradionecrosis in adults, occurring as late complications, are uncommon, but can be observed even nearly 80 years after radiation. Large defects of the skull require a complete reconstruction to avoid several complications.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9

Similar content being viewed by others

References

  1. Frenzel M, Ricoul M, Benadjaoud MA, Bellamy M, Lenain A, Haddy N, Diallo I, Mateus C, de Vathaire F, Sabatier L (2017) Retrospective cohort study and biobanking of patients treated for hemangioma in childhood - telomeres as biomarker of aging and radiation exposure. Int J Radiat Biol 93(10):1040–1053

    Article  CAS  PubMed  Google Scholar 

  2. Zheng JW, Zhang L, Zhou Q, Mai HM, Wang YA, Fan XD, Qin ZP, Wang XK, Zhao YF (2013) A practical guide to treatment of infantile hemangiomas of the head and neck. Int J Clin Exp Med 6(10):851–860

    PubMed  PubMed Central  Google Scholar 

  3. Silvestre-Rangil J, Silvestre FJ (2011) Clinico-therapeutic management of osteoradionecrosis: a literature review and update. Med Oral Patol Oral Cir Bucal 16(7):e900–e904

    Article  PubMed  Google Scholar 

  4. Dondon MG, Vathaire F, Shamsaldin A, Doyon F, Diallo I, Ligot L, Paoletti C, Labbé M, Abbas M, Chavaudra J, Avril MF, Fragu P, Eschwège F (2004) Cancer mortality after radiotherapy for a skin hemangioma during childhood. Radiother Oncol 72(1):87–93

    Article  PubMed  Google Scholar 

  5. Arun Kumar KV, Singla NK, Gowda ME, Kumar D, Legha VS (2014) Current concepts in restoring acquired cranial defects. J Indian Prosthodont Soc 14(Suppl 1):14–17

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Beumer J 3rd, Firtell DN, Curtis TA (1979) Current concepts in cranioplasty. J Prosthet Dent 42(1):67–77

    Article  PubMed  Google Scholar 

  7. Persson J, Helgason B, Engqvist H, Ferguson SJ, Persson C (2018) Stiffness and strength of cranioplastic implant systems in comparison to cranial bone. J Craniomaxillofac Surg 46(3):418–423

    Article  PubMed  Google Scholar 

  8. Engstrand T, Kihlström L, Lundgren K, Trobos M, Engqvist H, Thomsen P (2015) Bioceramic implant induces bone healing of cranial defects. Plast Reconstr Surg Glob Open 3(8):e491

    Article  PubMed  PubMed Central  Google Scholar 

  9. Dujovny M, Aviles A, Agner C, Fernandez P, Charbel FT (1997) Cranioplasty: cosmetic or therapeutic? Surg Neurol 47(3):238–241

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Oral and Maxillofacial Surgery and Plastic Operations, Central Medical Centre Bremen, Bremen, Germany

    Birte Julia Siegmund & Jan Rustemeyer

Authors
  1. Birte Julia Siegmund
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jan Rustemeyer
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Birte Julia Siegmund.

Ethics declarations

Competing interests

None of the authors have any conflict of interest to declare.

Ethical approval

Not required.

Patient consent

The subscribed patient consent declaration form is attached to the submission of this manuscript.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Siegmund, B.J., Rustemeyer, J. Case report: chronic inflammatory ulcer and osteoradionecrosis of the skull following radiotherapy in early childhood. Oral Maxillofac Surg 23, 239–246 (2019). https://doi.org/10.1007/s10006-019-00752-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10006-019-00752-7

Keywords

Search

Navigation