Squamous Cell Carcinoma Metastasis to the Supraclavicular Artery Island Flap Donor Site

Abstract

A rare complication of flap reconstruction following oncologic ablation is metastasis to the donor site. We present a novel case of cutaneous squamous cell carcinoma (SCCA) recurrence at the right upper‐extremity donor site following tonsillar SCCA resection with supraclavicular artery island flap reconstruction. Following surgery, the patient presented with cutaneous recurrence at the right upper‐extremity donor site. Biopsy confirmed metastasis from the oropharyngeal primary. The patient developed two subsequent right upper‐extremity recurrences before he died. The most likely mechanism of metastasis is direct implantation via contamination. This case demonstrates the importance of maintaining separate surgical fields and instruments during oncologic ablation and reconstruction. Laryngoscope, 131:E440–E442, 2021

Left cheek sclerosing rhabdomyosarcoma and development of isolated free flap donor site metastasis

“…Pai et al described a case of iatrogenic implantation of high grade spindle cell sarcoma to the left thigh that occurred 8 years after initial surgery 12. Of note, there are infrequent reports of head and neck primary cancers with isolated graft/flap donor site metastasis or percutaneous endoscopic gastrostomy tumour implantation 13–16. In theory, although unlikely, cross-contamination might inadvertently occur somewhere along the course of the prolonged and complex head and neck surgery 14.…”