Reconstruction of the Anterior Chest for Radiation Ulcer and Radiation Sarcoma with Contralateral Pedicled Latissimus Dorsi Flap

Abstract

In patients with radiation ulcers or radiation sarcoma in the anterior chest, reconstruction with a free flap or a unilaterally pedicled flap is challenging. We describe 2 cases of defects reconstructed in the anterior chest with contralateral pedicled LD flaps.
The first patient, a 71-year-old woman who had suffered from breast cancer and had undergone radiation therapy and surgery 44 years previously, presented with a radiation ulcer in the anterior chest. The ulcer and scar tissue were excised, and the defect was covered with a contralateral pedicled LD flap. The second patient, an 80-year-old woman who had suffered from breast cancer and had undergone radiation therapy and surgery 35 years previously, presented with a mass at the left clavicle. The mass, diagnosed by biopsy as post-radiation sarcoma, was excised, and the defect was covered with a contralateral pedicled LD flap. Neither of the patients demonstrated recurrence or necrosis of the flap.
In conclusion, a pedicled LD flap can cover the defect in the contralateral anterior chest and is useful for reconstruction in patients with radiation ulcers or tumors.