Some cases of squamous cell carcinoma (SCC) arising in free flaps have been reported by several authors. We report herein two cases of squamous cell carcinoma arising in free flaps after oral reconstruction.
The first case was a 76-year-old woman. Nine years before admission, she received resection of a left buccal mucosal SCC and left radical neck dissection. The defect was reconstructed with an anterolateral thigh flap. On a routine examination, a new SCC was noted in the center of the anterolateral thigh flap. The tumor was simply resected. After resection of the SCC, there has been no recurrence for 15 months.
The second case was a 70-year-old woman. Nineteen years before admission, she received resection of an SCC of the right tongue after radiotherapy, and the defect was reconstructed with a forearm flap. She subsequently received tumor resection of an SCC of the left tongue. Four years before admission, right SCC was found in the lower gingival tissue, and she received both radial neck dissection and mandibulectomy. The defect was reconstructed with an anterolateral thigh flap. On a routine examination, a new SCC was noted between the left tongue and the anterolateral thigh flap. The SCC was resected with safety margin. After resection of the SCC, the patient is alive no recurrence for 9 months.
Long-term follow up of these patients demands careful examination of the mucosa of upper digestive tract and the surface of the flap used for reconstruction.
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