Cancer Recurrence Involving a TRAM Flap and Abdominal Donor Site Following Mastectomy and Immediate Breast Reconstruction

Kobraei, Edward M.; Kenady, Daniel E.; Rogers, Weaver B.; Rinker, Brian

doi:10.1097/sap.0b013e318216e6ce

Cited by 5 publications

(1 citation statement)

References 16 publications

(11 reference statements)

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“…A few reports described immediate autogenous reconstruction by transverse rectus abdominis musculocutaneous (TRAM) flap and latissimus dorsi (LD) musculocutaneous flap [16][17][18][19]. Kobraei et al [19] reported a case of malignant PT that recurred after mastectomy with immediate TRAM flap reconstruction. The recurrent disease involved the mastectomy bed, TRAM flap, abdominal donor site, and precostal tunnel.…”

Section: Discussionmentioning

confidence: 99%

A case of recurrent malignant phyllodes tumor undergoing nipple-sparing mastectomy with immediate breast reconstruction

Morioka

Noguchi

et al. 2020

surg case rep

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Background Although the primary treatment for malignant phyllodes tumor (PT) is complete surgical excision with either breast-conserving surgery or total mastectomy, recent technical advances have led to the adoption of nipple-sparing mastectomy (NSM) with immediate breast reconstruction (IBR). Case presentation A 28-year-old woman noticed a mass in her left breast that was rapidly increasing in size. She underwent tumor excision and a histological diagnosis of marked degenerative and necrotic induration suggested benign PT. One year later, however, she was found to have recurrent masses in the left breast on follow-up mammography and sonography. Needle biopsy was performed and the tumor was diagnosed as borderline or malignant PT. She underwent NSM and sentinel lymph-node biopsy with IBR using a tissue expander. Histological examination of the mastectomy specimen showed multiple fibroepithelial tumors with marked stromal overgrowth, focal necrosis, and hemorrhage. Stromal cells showed pleomorphism and a maximal mitotic rate of approximately 25 per 10 high-power fields. The tumor was diagnosed as malignant PT. She did not receive adjuvant chemotherapy or radiation treatment. At 3-year follow-up, the patient remains free of disease and highly satisfied with the cosmetic results. Conclusions NSM with IBR is not a contraindication for malignant PT. It is both curative and can offer an appealing cosmetic option for localized malignant PT.

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Section: Discussionmentioning

confidence: 99%

A case of recurrent malignant phyllodes tumor undergoing nipple-sparing mastectomy with immediate breast reconstruction

Morioka

Noguchi

et al. 2020

surg case rep

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Lymphatic drainage study after latissimus dorsi flap breast reconstruction

et al. 2014

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Background Recurrence of breast cancer to latissimus dorsi (LD) flap donor site is a very rare condition, and as a result, few data are currently available on its possible causes. The aim of the study was to investigate the role of LD flap transfer in lymphangiogenesis and connection to the preexisting lymphatic network after mastectomy and axillary lymph node dissection and the lymphatic drainage involvement in local relapse to flap donor site. Methods Lymphoscintigraphy was performed on subgroup of ten patients who had previously undergone modified radical mastectomy, axillary lymph node dissection, and pedicled LD flap reconstruction. Lymphatic drainage was imaged by static gamma camera acquisitions after two intradermal injections of 37 MBq 99mTc-Nanocoll® on residual breast skin and LD skin paddle, respectively. Results In eight cases (80 %), the residual breast skin showed fast lymphatic drainage directed only toward the ipsilateral axilla, while in two cases (20 %), it was also seen to the internal mammary nodes. LD skin paddle showed slower drainage in all cases but 1, where no visible drainage was observed within 2 h after injection. Conclusions Although a small case series is the study limitation, our findings suggested that the LD flap harvest can promote a preferential route of lymphatic drainage in the axillary region and could be involved in a metastatic spread to the dorsum because of the new tissue plane opening. The direct communication created between recipient and donor sites could have lead to cell cancer transfer to the donor site either by lymphatic or a contiguity pathway.Level of Evidence: Level V, diagnostic study. © 2014 Springer-Verlag Berlin Heidelberg

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The Contact Zone: A Common Site of Tumor Recurrence in a Patient Who Underwent Skin-Sparing Mastectomy and Myocutaneous Flap Reconstruction

Al-Khalili

Wynn

2016

Current Problems in Diagnostic Radiology

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Cancer Recurrence Involving a TRAM Flap and Abdominal Donor Site Following Mastectomy and Immediate Breast Reconstruction

Cited by 5 publications

References 16 publications

A case of recurrent malignant phyllodes tumor undergoing nipple-sparing mastectomy with immediate breast reconstruction

A case of recurrent malignant phyllodes tumor undergoing nipple-sparing mastectomy with immediate breast reconstruction

Lymphatic drainage study after latissimus dorsi flap breast reconstruction

The Contact Zone: A Common Site of Tumor Recurrence in a Patient Who Underwent Skin-Sparing Mastectomy and Myocutaneous Flap Reconstruction

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