Free flap transfer reconstruction in managing tongue carcinoma during pregnancy

Abstract

Malignant oral cancers do not commonly occur in pregnant women. But when they do, the presence of a foetus and maternal physiological changes complicate and limit the treatment options. Risk benefit assessment and balancing of them are always important. A 33-year-old woman, who was 25 weeks pregnant, presented with a squamous cell carcinoma on her tongue. She was clinically staged II (T2, N0 and M0). Discussions between the patient, surgical teams and obstetricians agreed to continue her pregnancy while managing the tumour. Hemi-glossectomy and ipsilateral neck dissection was performed. Free antero-lateral thigh flap was transferred to reconstruct the tongue defect, successfully. The patient gave birth to a healthy baby afterward. She is tumour free for 6 years. Free flap reconstruction can be an option, even if the patient is pregnant.

Multi-Region Sequence Analysis of a Pregnancy-Related Oral Squamous Cell Carcinoma Exhibiting Low-Level Aggressive Behavior

“…The absence of genetic and epigenetic alterations in the surrounding non-neoplastic mucosa indicates that a field cancerization effect did not apply in the present case of pregnancy-related OSCC. [28][29][30][31][32][33][34][35][36] The "not aggressive" molecular profile found in the present case is consistent with the positive prognosis of our patient (still alive without any local relapse after 8 years of follow-up), but apparently in contrast with the clinicopathological characteristics (advanced stage, rapidly growing, bone involvement, and the presence of lymph node metastases).…”

“…However, data on pregnancy-related OSCCs are few in number because of the rarity of the reported cases. [7][8][9][14][15][16]20,25,35 In the present study, we performed genetic and epigenetic evaluations of a pregnancy-related OSCC, and we evaluated the adjacent non-neoplastic mucosa in order to verify the presence of field cancerization. A panel of specific driver genes related to OSCC carcinogenesis tested in our recent study 27 was used to determine the genetic profile of the tumor.…”

Microvascular free flap in a pregnant patient after resection of a high-grade neuroendocrine carcinoma

“…Circulating fibrin and other coagulation factors rise, platelet exchange is accelerated, and fibrinolytic activity is reduced. These processes contribute to a hypercoagulable state, increasing the risk of anastomosis thrombosis and thromboembolic complications (9).…”