2021 Volume 64 Issue 2 Pages 113-117
Various cutaneous flaps have been utilized for tissue reconstruction in patients undergoing operations in the head and neck region, and a few cases of carcinoma developing from the reconstructed flap itself have been reported. Herein, we report a rare case of carcinoma arising from a pectoralis major musculocutaneous flap 30 years after the patient underwent operation for oropharyngeal squamous cell carcinoma.
A 78-year-old male patient consulted our department with a history of gradually worsening dysphagia and weight loss. Upper gastrointestinal endoscopy revealed a whitish papillary tumor on the surface of the reconstructed flap. Biopsy was performed and the histological diagnosis was benign squamous papilloma. Although endoscopic tumor resection was attempted three times, no improvement in the dysphagia was noted. Therefore, complete flap resection and reconstruction using a vascularized free jejunal autograft was performed. To our surprise, the final histological diagnosis obtained from examination of the resected specimen was verrucous carcinoma. We wish to emphasize the importance of long-term follow-up of patients undergoing reconstructive surgery is vital, in view of the small, but definite risk of secondary carcinoma arising from the reconstructed cutaneous flap itself.
