Background: Phyllodes tumor (PT) is a rare tumor of the breast, which may occur during pregnancy or lactation. Several studies have reviewed and discussed PT occurring in pregnancy, gathering up to 14 patients. We performed a thorough systematic review of the literature in an attempt to find all reported cases, and identify their common characteristics. Methods: We searched Google scholar, PubMed, Ovid Medline, Scopus and ClinicalTrials.gov with several relevant combinations of keywords, looking for texts or abstracts without any date or language limitations, but using only English keywords. The existing literature only consisted of case reports and series; therefore any paper including one or several cases of PT presenting during pregnancy or breastfeeding was recognized as eligible. Articles with vague description of the tumor which made the diagnosis uncertain, and those lacking data about the tumor and management data were excluded. We contacted authors for more details in cases with incomplete information. Results: After excluding those with very deficient data, we included 37 studies, counting 43 cases. The mean age of the patients was 31 years (21-43 years). Some features were different from usual PT: bilaterality (16.2%), large size (14.2 ± 8.6 cm), rapid enlargement (79.5%), and rate of malignancy (60.5%). Conclusion: Our findings show high rates of bilaterality, large size, rapid growth, and malignant pathology in the reported gestational PTs.

No abstract

Background: Advances in limb-salvage techniques have made total calcanectomy and primary reconstruction possible in managing calcaneal aggressive benign tumors and selected cases of intraosseous malignant tumors. However, there is still no consensus on the operative approach, oncologic margin, and the best reconstruction method to date. These 2 cases describe our experience in calcaneal reconstruction with the free deep circumflex iliac artery (DCIA) osseocutaneous flap in benign aggressive calcaneal tumors. Methods: We reported 2 consecutive male and female patients, with an average age of 25 years (age 19 and 31, respectively), who underwent total calcanectomy and primary calcaneal reconstruction with the free DCIA osseocutaneous flaps for calcaneal chondroblastoma and giant cell tumor. A marginal resection of the entire calcaneus through the subtalar and calcaneocuboid joints (intra-articular approach) was performed in the first case and a wide local resection leaving 1 cm normal calcaneal bone margin anterosuperiorly (intraosseous approach) was performed in the second case. Results: The follow-up period averaged 48 months. Negative oncologic margins were achieved in both cases. The first case was complicated with venous thrombosis; however, the graft remained viable after emergency reexploration. Normal foot function was restored with good solid osseous union and bony hypertrophy observed. Both patients achieved good short-term functional and aesthetic outcomes with no donor site pain or disability. No local recurrence was reported either. Conclusion: Primary calcaneal reconstruction with the free DCIA osseocutaneous flap can lead to good short-term functional and aesthetic outcomes. Level of Evidence: Level IV, case series.

This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon.

No abstract

The reverse abdominoplasty technique has uses that extend past cosmetic surgery into the field of reconstructive surgery. With a thorough understanding of the technique and modifications, this method may be used to cover extensive chest wall defects post-mastectomy in select patients. Reconstructive algorithms for locally advanced breast cancer tend to favor microsurgical techniques. However, the surgeon needs to choose the optimal reconstructive option based on the defect size, disease stage, future oncological therapeutic approach, and patients’ general condition. Patients with aggressive forms of breast cancer have higher risks of recurrence despite advances in chemotherapy. This subset of patients may be poor responders to adjuvant or neoadjuvant oncological drugs, may require postoperative radiotherapy, or be at high risk for early recurrence. In this subset of patients, we advocate the use of a reverse abdominoplasty for immediate autologous soft tissue coverage of the chest wall after breast cancer resection. It provides a robust soft tissue cover for radiotherapy and spares potential future autologous donor sites for delayed breast reconstruction while facilitating early clinical detection of recurrence. Here, we discuss a case treated with this technique and explore the surgical technique, pitfalls, and advantages of this technique with the outcome that validates decision-making.

No abstract

No abstract