Implantation of Squamous Cell Carcinoma in a Free Flap Donor Site

2020 ◽  
Vol 129 (9) ◽  
pp. 935-940
Author(s):  
Priscilla Pichardo ◽  
Nicholas Purdy ◽  
Thorsen Haugen
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Free Flap ◽  
Donor Site ◽  
Case Presentation ◽  
Tumor Implantation ◽  
Radial Forearm ◽  
Subcutaneous Tissues

Introduction: It is well known that malignant cells can be implanted at distant donor sites due to iatrogenic surgical contamination. Only a small number of reports, however, have been published describing this. Case Presentation: We present a case of oral cavity Squamous Cell Carcinoma (SCC) reconstructed with a radial forearm free flap in which SCC developed in the subcutaneous tissues beneath the donor incision site 6 months after surgery. Management: The implanted tumor was excised and the field was subsequently treated with radiation. The patient remains disease-free on follow-up. Discussion: We present the second report of tumor implanted in a free flap donor site. Additionally, we discuss the risks of tumor implantation, review the literature, and make recommendations to avoid this complication.

scholarly journals Free radial forearm flap for reconstruction of postoperative defects in combined and complex treatment of patients with locally-advanced squamous cell carcinoma of the oral cavity

2020 ◽  
Vol 10 (1) ◽  
pp. 55-64
Author(s):  
H. Chen ◽  
A. M. Mudunov ◽  
R. I. Azizian ◽  
I. N. Pustynskiy ◽  
O. A. Saprina ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Oral Cavity ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Free Flap ◽  
Locally Advanced ◽  
Functional Results ◽  
Radial Forearm Free Flap ◽  
Flap Necrosis ◽  
Radial Forearm

The study objective is to assess immediate and long-term results of replacing complex defects with a free radial forearm flap in the multimodal treatment of patients with locally advanced oral cavity squamous cell carcinoma. Materials and methods. Twenty eight patients (20 women and 8 men aged 23 to 71 years) with locally advanced oral cavity squamous cell carcinoma (including 10 buccal cancers, 8 carcinomas of tongue, 6 carcinomas of the floor of the mouth, 2 retromolar area carcinomas, 1 carcinoma of the hard palate and 1 carcinoma of alveolar region of the lower jaw) underwent tumor surgery with simultaneous plastic reconstruction of the defect using radial forearm free flap at the department of head and neck tumors of N. N. Blokhin National Medical Research Center of Oncology within 2010–2018. Primary tumors were detected in 2 patients and 11 patients had residual (n = 7) or recurrent (n = 4) tumors after radiotherapy or chemoradiotherapy. Results. An overall success rate was 96.4 %. Postoperative histology revealed that there were no tumor cells at the resection edges. Postoperative complications included: complete flap necrosis in 1 patient with severe concomitant diseases, marginal flap necrosis in 2 patients (in both cases after the necrotic tissue had rejected, wounds were healed by secondary intention), sural veins thrombosis in 1 patient, acute peptic ulcer bleeding on the 6th day after surgery in 1 patient treated with emergency endoscopic hemostasis. No lethal outcomes were reported. Postoperative period lasted in average 14 days. Upon subsequent observation tumor relapse in the oral cavity occurred in 4 (14.3 %) patients, relapses of regional metastases – in 2 (7.1 %). Good aesthetic and functional results were noted. Adequate restoration of breathing, chewing, swallowing and speaking resulted in a full patients’ rehabilitation. In all cases, the radial flap adapted well to the oral cavity organs and corresponded to the surrounding tissues in thickness and consistency. Conclusion. Use of a radial forearm free flap makes it possible to successfully reconstruct extensive and complex defects after surgery of locally advanced primary and recurrent forms of oral cavity squamous cell cancer of various locations. Due to flap’s high regenerative capabilities, preoperative radiation therapy does not affect the frequency of local complications. It allows restoring vital functions of the oral cavity and achieving good aesthetic and functional results.

scholarly journals Management of Squamous Cell Carcinoma in a Chronic Sacrococcygeal Pilonidal Cyst: A Case Report

2020 ◽  
pp. 1-4
Author(s):  
Ziad El Rassi ◽  
Charbel Aoun ◽  
Hani Maalouf ◽  
Saleem Abdel Backi ◽  
Toufic Saber ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Malignant Transformation ◽  
Squamous Cell ◽  
Pilonidal Disease ◽  
Surgical Excision ◽  
High Rate ◽  
Pilonidal Cyst ◽  
Subcutaneous Tissues

Introduction: Pilonidal disease is a chronic inflammatory process resulting from impaction of natal cleft hair into the subcutaneous tissues creating an abscess or a draining sinus over the sacrococcygeal area. Malignant transformation occurs in around 0.1%, mainly into squamous cell carcinoma (SCC) type. Wide excision with tumor-free margins remains the treatment of choice. Multiple closure techniques were settled and the best one ought to be chosen in a context malignancy and future radiological treatment. Case Presentation: We describe the management of a case of a 69-year-old male with chronic pilonidal disease, recurrent after 25 years found on final pathology to undergo malignant transformation into SCC. Wide and aggressive excision were performed with new margins and with periosteal excision of the sacrum and coccyx. rotational myocutaneous gluteal flap was done for closure of the wound in order to ensure better satisfactory esthetic results without a delay in future treatment. Conclusion: The progression of a chronic pilonidal disease into SCC is a rare but serious complication. The diagnosis is confirmed by biopsies. Workup for metastasis should be made before aggressive surgical excision. Oncoplastic surgeries is recommended for satisfactory results. Routine follow-up postoperatively should be considered due to high rate of recurrence by physical examination and imaging.

scholarly journals A case report of carcinoma of uterine cervix throwing heterochronous metastasis to the skin, spleen, and pancreas: the role of multimodality treatment approach

2019 ◽  
Vol 31 (1) ◽  
Author(s):  
P. K. Gupta ◽  
P. Lal ◽  
A. Tiwari
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Palliative Radiotherapy ◽  
Multimodality Treatment ◽  
Salvage Chemotherapy ◽  
Case Presentation ◽  
Local Site ◽  
Work Up

Abstract Background Cancer of cervix often fails locally and/or within the pelvis. One to two percent of cervical squamous cell carcinoma patients have lung metastases at presentation, and 5–35% develop pulmonary metastases later on. Common sites of metastases are the liver, bone, and bowel. We report a rare case presentation of cervical squamous cell cancer where heterochronous metastasis occurred in the skin, spleen, and pancreas without loco-regional recurrence and skipping of visceral organs such as the lung, liver, and brain. Case presentation A 55-year-old, postmenopausal lady presented with a complaint of bleeding of the vagina for 2 months duration. Cervical biopsy revealed squamous cell carcinoma of the cervix, and she was staged as a case of FIGO stage IIIB. She received external beam-beam radiotherapy of 50 Gy in 25 fractions along with concurrent weekly cisplatin at 35 mg/m2 followed by 3 fractions of intracavitary brachytherapy of 6 Gy each. After 30 months of follow-up, she presented with a skin lesion of 6 × 5 cm2 in the infrascapular region for 2 months duration. Biopsy revealed metastatic squamous cell carcinoma. Her metastatic work-up revealed no other lesions. Palliative radiotherapy to local site of 8 Gy in single fraction was delivered. The lesion disappeared within 4 weeks. She was given 6 cycles of cisplatin and paclitaxel salvage chemotherapy. After 30 months of follow-up, she presented with a skin lesion of 6 × 5 cm2 in the infrascapular region. Biopsy revealed metastatic squamous cell carcinoma. Her metastatic work-up revealed no other lesions. Palliative radiotherapy to the local site was planned, and a dose of 8 Gy in a single fraction was delivered. The lesion disappeared within 4 weeks. She was given 6 cycles of cisplatin and paclitaxel salvage chemotherapy. Six months after the completion of salvage therapy, she reported with the complaints of recurrent bouts of hematemesis and melena. Her CECT scan revealed 2 × 1.5 cm2 growth in the body of the pancreas and a subcentric splenic hilum node. She underwent open splenectomy with distal pancreatectomy. Histopathology report showed metastatic infiltration in pancreatic tissue by squamous cell carcinoma and one metastatic node in the splenic hilum. Post-treatment, 6 months, the patient was asymptomatic with no recurrence. Conclusions This is a rare heterochronous metastatic presentation of cervical cancer without loco-regional recurrence and visceral organs such as the lung, liver, and brain. The optimal treatment remains undefined for these patients. Multimodality treatment is necessary to manage the patients.

scholarly journals Isolated Donor site Tumour Recurrence at Pectoralis Major Myocutaneous Flap in Oral Cavity Squamous Cell Carcinoma – A Rare Case Report and Review of Literature

2021 ◽  
Author(s):  
Prathamesh Chandrapattan ◽  
Sangram Keshari Panda ◽  
Pradyumna Kumar Sahoo ◽  
Chira Khadanga ◽  
Sunil Agrawala
Keyword(s):  
Squamous Cell Carcinoma ◽  
Oral Cavity ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Donor Site ◽  
Pectoralis Major ◽  
Curative Intent ◽  
Rare Case Report ◽  
Left Subclavian Vein

Abstract Background: Pectoralis Major MyoCutaneous (PMMC) flap has been commonly used since decades for plastic reconstruction in oral cavity cancer surgery. However, rarely the PMMC donor site develops tumor recurrence. Management includes surgical resection in unifocal lesion or salvage radical chemoradiotherapy in clinico-radiologically nonmetastatic unresectable disease which results in satisfactory tumor related outcomes.Case presentation: A 46 year gentleman known case of Squamous Cell Carcinoma left Retromolar Trigone after surgery and adjuvant radiotherapy presented with isolated recurrence at PMMC flap donor vascular pedicle site which was abutting left subclavian vein and so was managed with concurrent chemo-radiotherapy with curative intent and is on follow up since 2 years with no evidence of recurrence.Conclusions: Isolated PMMC flap donor site recurrence in oral cavity squamous cell carcinoma management is complex, with surgical intervention with excision of such lesions in absence of any other deposits is preferable approach. Concurrent CTRT is an alternative option in curative intent when the lesion is not surgically resectable or the patient refuses surgery.

scholarly journals First report of squamous cell carcinoma arising within an intraoral radial forearm free flap

2013 ◽  
Vol 4 (8) ◽  
pp. 731-734 ◽  
Author(s):  
James A. Cymerman ◽  
Raghav Kulkarni ◽  
David Gouldesbrough ◽  
James A. McCaul
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Free Flap ◽  
Radial Forearm Free Flap ◽  
First Report ◽  
Radial Forearm

scholarly journals Anti-TIF1 gamma-positive IPAF patient developed stage IVB lung squamous carcinoma in 1 year: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jiao-jiao Xie ◽  
Bin Li ◽  
Rui Xu ◽  
Xian-zhi Du ◽  
Jin-zhi He
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Malignant Tumors ◽  
Lung Squamous Cell Carcinoma ◽  
Squamous Carcinoma ◽  
Case Presentation ◽  
Stage Ivb ◽  
The Relationship

Abstract Background Patients with connective tissue disease, such as dermatomyositis (DM), and positive anti-TIF1γ self-antibodies are commonly diagnosed with malignant tumors as a comorbidity. The relationship between anti-TIF1γ self-antibodies and existing malignant tumors has been confirmed by several reports. However, interstitial pneumonia with autoimmune features (IPAF) cases with a positive anti-TIF1γ self-antibody developing to solid malignant tumors are rarely reported now. Case presentation Herein, we presented an IPAF patient with anti-TIF1γ self-antibodies. No evidence of malignant tumors was found at the initial visit. However, the patient had developed stage IVB lung squamous cell carcinoma at the 1-year follow-up review. Conclusions Altogether, this report described a rare case of IPAF patient with anti-TIF1γ self-antibodies developed to advanced lung squamous cell carcinoma in 1 year. The present case highlights more frequent imaging examinations to identify the occurrence of malignant tumors as early as possible in IPAF patients with positive anti-TIF1γ self-antibodies.

scholarly journals Radiotherapy for Esophageal Squamous Cell Carcinoma Concomitant With Hypoproteinemia: a Case Report

2021 ◽  
Author(s):  
Zhongfei Jia ◽  
Wenxi Wang ◽  
Jie Yang ◽  
Meng Song ◽  
Yuxiang Wang
Keyword(s):  
Squamous Cell Carcinoma ◽  
Esophageal Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Reference Range ◽  
Malignant Tumors ◽  
Case Presentation ◽  
Fresh Plasma ◽  
Upper Abdomen

Abstract Background: Malignant tumors frequently combined with hyperfibrinogenemia, rarely with hypofibrinogenemia.Case presentation: This study reports a 60-year-old male patient of mid-thoracic esophageal squamous cell carcinoma (ESCC) with hypofibrinogenemia who presented at our hospital because of a swallowing disorder and dull pain in the upper abdomen. An initial test indicated his plasma fibrinogen (FIB) level was 0.88 g/L (reference range: 2.38–4.98 g/L). After multiple infusions of fresh plasma and supplements of FIB and cryoprecipitate, he maintained a FIB level above 1.0 g/L. We administered radical radiotherapy (RT) for the ESCC, and his FIB level gradually normalized during the RT period. The symptoms from ESCC gradually resolved, and we classified the patient as having stable disease at the end of the RT period. After 10 months follow-up, the patient have achieved partial response (PR). At that time, the patient had no increased tendency for bleeding and his FIB level was 0.97 g/L. At the last follow-up, the patient has survival about 18 months. Conclusions: it was considered the hypofibrinogenemia in this ESCC patient to be a consequence of paraneoplastic syndrome.

scholarly journals Oral findings during follow-up of nasopharyngeal squamous cell carcinoma treatment: A case report

2021 ◽  
Vol 9 ◽  
pp. 2050313X2110330
Author(s):  
Atsushi Musha ◽  
Nobuteru Kubo ◽  
Naoko Okano ◽  
Hidemasa Kawamura ◽  
Yuhei Miyasaka ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Concurrent Chemoradiotherapy ◽  
Nasopharyngeal Cancer ◽  
Inflammatory Conditions ◽  
Positron Emission ◽  
History Of ◽  
Oral Area

A 50-year-old woman with a long history of nasopharyngeal cancer (T2N2M0, squamous cell carcinoma) underwent chemoradiotherapy and surgery. In the past, to prevent tumor recurrence or metastasis, she underwent concurrent chemoradiotherapy or neck dissection. However, during a follow-up 10 years after the surgery, intense F-18 fluorodeoxyglucose uptake was detected in the oral area (SUVmax 6.0). A biopsy of the area with F-18 fluorodeoxyglucose uptake revealed pathological inflammation. Radiography showed the presence of a wisdom tooth, located at the F-18 fluorodeoxyglucose accumulation site, and pericoronitis of this tooth was detected. Our findings indicate the importance of considering the effect of inflammatory conditions, such as periodontal disease, in using F-18 fluorodeoxyglucose positron emission tomography/computed tomography during follow-up after head and neck cancer treatment.

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