Squamous Cell Carcinoma of the Pectoralis Major Myocutaneous Flap Donor Site

Mohan, Alok; Balaguhan, B.; Krishna, Vinod; Nagarjuna, Muralidhara

doi:10.1016/j.joms.2013.12.021

Cited by 5 publications

(7 citation statements)

References 22 publications

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“…Primary metastasis to the flap donor site is a rare complication of flap reconstruction, first reported in 1981 following cross‐leg flap for reconstruction of a fibrosarcoma resection defect 5 . Seeding of the donor site by head and neck SCCA has been described following use of a split thickness skin graft 6 and a variety of reconstructive flaps 7–11 . This case is the first report of head and neck primary SCCA recurrence at an SAI flap donor site.…”

Section: Discussionmentioning

confidence: 90%

“…Lastly, tumor metastasis can occur via implantation either by spontaneous seeding or by iatrogenic contamination during surgery 7 . Contaminated instruments or equipment has been proposed as a probable cause of donor site seeding in several case reports 8,9 and is the most likely mechanism of recurrence in this patient. This theory is further supported by the lack of other metastatic disease, which would be expected with lymphatic or hematogenous spread.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2020

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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

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

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

et al. 2020

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“…We consider that the PMMF may not be large enough to allow reconstruction of major through‐and‐through defects and may not be long enough for application to the skull base. Additionally, accidental displacement of a pectoralis major flap by a breast tissue adenocarcinoma and SCC developing in the PMMF donor site have been reported . A much higher proportion of female patients received TIMFs (52.4%) than PMMFs (16.5%); use of a TIMF is preferred in women when myocutaneous flaps are not ideal.…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, accidental displacement of a pectoralis major flap by a breast tissue adenocarcinoma and SCC developing in the PMMF donor site have been reported. 15,16 A much higher proportion of female patients received TIMFs (52.4%) than PMMFs (16.5%); use of a TIMF is preferred in women when myocutaneous flaps are not ideal.…”

Section: Discussionmentioning

confidence: 99%

“…16.5 months in the TIMF and 15.1 months in the PMMF group). At final follow-up, 15 patients (71.4%) in the TIMF group and 14 (77.8%) in the PMMF group were alive with no evidence of disease, 3 in the TIMF group and 1 in the PMMF group were alive with disease, and 6 patients in each group died of local recurrence or distant metastases between 6 and 36 months (Tables 1 and 2).…”

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confidence: 86%

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Extended vertical lower trapezius island myocutaneous flap versus pectoralis major myocutaneous flap for reconstruction in recurrent oral and oropharyngeal cancer

et al. 2015

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Supraclavicular Artery Island Flap: Critical Appraisal and Comparison to Alternate Reconstruction

et al. 2020

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Objectives/Hypothesis: The supraclavicular artery island (SAI) flap may be a good option for selected head and neck reconstruction due to its reliability, ease of harvest, and favorable color match. The objective of this study was to examine the rates of complications for the SAI flap in head and neck oncologic reconstruction, with examination of risk factors and comparisons to alternative flaps often considered the gold-standard soft-tissue flaps for head and neck reconstruction: the pectoralis myocutaneous (PMC), radial forearm free flap (RFFF), and anterolateral thigh (ALT) flaps.Study Design: Retrospective cohort study. Methods: Consecutive SAI flaps were compared to PMC, RFFF, and ALT flaps (non-SAI flap group), all performed by the senior author from 2010 to 2018. The non-SAI flaps were included if an SAI flap could have been performed as an alternate flap. The groups were compared based on demographics, flap dimensions, site of reconstruction, operating time, total hospital stay, total hospital costs, and complications.Results: One hundred seven SAI flaps and 194 non-SAI flaps were identified. SAI flaps were used less commonly than non-SAI flaps for mucosal defects (P < .001). The SAI flap dimensions were narrower but longer than non-SAI flaps (P < .001). SAI flaps had higher rates of total complications, partial flap necrosis, flap dehiscence at the recipient site, fistula, donor site dehiscence, and minor complications compared to non-SAI flaps (all P < .05). SAI flaps had higher rates of total complications, recipient site dehiscence, fistula, and minor complications in both the oral cavity and all mucosal sites compared to non-SAI flaps (all P < .05). SAI flaps for mucosal reconstruction were associated with higher rates of total complications (54% vs. 34%, P = .04), flap dehiscence at the recipient site (32% vs. 14%, P = .03), and major complications (21% vs. 5%, P = .02), compared to cutaneous reconstruction. Complications were equivalent between SAI flaps and non-SAI flaps for cutaneous reconstruction (all P > .05). Multivariate analysis showed that SAI flaps were associated with any postoperative complication (odds ratio [OR]:

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Squamous Cell Carcinoma of the Pectoralis Major Myocutaneous Flap Donor Site

Cited by 5 publications

References 22 publications

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

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

Extended vertical lower trapezius island myocutaneous flap versus pectoralis major myocutaneous flap for reconstruction in recurrent oral and oropharyngeal cancer

Supraclavicular Artery Island Flap: Critical Appraisal and Comparison to Alternate Reconstruction

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