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

Abstract

Free flap reconstruction is seldom performed during pregnancy. Not only does the prolonged operative time pose a risk for the mother and the fetus, but also the hypercoagulable state of pregnancy predisposes the mother to a greater risk of complications in the transplanted tissue. We present a case of a 29-year-old patient in week 27 of gestation with a rapidly progressive neuroendocrine tumor in the left nasal fossa with involvement of the nasal sinus, pterygopalatine fossa, dura, and left orbit, associated with neurological symptoms and recurrent epistaxis. The aggressive and rapidly progressive character of the tumor made surgical excision by a multidisciplinary team as the first option. We performed immediate reconstruction with an anterolateral thigh free flap. Free tissue transfer was performed successfully, with satisfactory results on the mother and later delivery without complications.