A 68 year-old female presents with an ulcerated mass of the 5th digit, with rapid growth during the previous month to surgery. The mass was excised and covered with a 4th dorsal metacarpal artery perforator flap. The histologic analysis was compatible with the diagnosis of fibro-osseous pseudotumor of the digit.

The most used vessels for free flap breast reconstruction are the internal mammary, the thoracodorsal and the circumflex scapular. We present a case where those were inadequate. DIEP vessels were passed through a created sternal groove and anastomosed to the contralateral IM vessels, accessed by the breast symmetrisation incisions.

An 18-year-old boy presented with a giant midline mass with 9 years of evolution. The tumor was excised, and reconstruction made with a customized sternum implant and a free latissimus dorsi muscle flap with skin graft. Histological analysis was compatible with low-grade fibromyxoid sarcoma (LGFMS).