Left cheek sclerosing rhabdomyosarcoma and development of isolated free flap donor site metastasis

Abstract

Rhabdomyosarcoma is a rare mesenchymal malignancy with four different morphological subtypes: alveolar, embryonal, pleomorphic and spindle cell/sclerosing. It is the most common soft tissue sarcoma of children and adolescents but occurs less commonly in adults. We describe a male patient in his 20s with sclerosing rhabdomyosarcoma of the left cheek who developed an isolated free flap donor site metastasis in the first instance but subsequently progressed with bilateral pulmonary metastases. Multidisciplinary team involvement in a sarcoma specialist centre is essential and collaboration between the pathologist, radiologist, head and neck surgeon, orthopaedic surgeon, radiation oncologist and medical oncologist were integral in providing optimal management in this patient. Furthermore, this case report highlights this phenomenon of implantation metastasis in a patient with rhabdomyosarcoma, and emphasises the importance of surgical barriers between the resection and reconstruction teams in an oncological case.

Oral Squamous Cell Carcinoma Metastasis to Anterolateral Thigh Flap Donor Site: A Case Report

“…a left sclerosing reconstructed with a left ALT free flap. 4 A 6-month surveillance wholebody FDG-PET demonstrated an intramuscular mass at the left rectus femoris muscle, confirmed as donor site metastasis. We add to this literature by unveiling a unique case of metastatic oral SCC to an ALT flap donor site (Table 1).…”

“…Donor site metastasis of an ALT flap has only been documented in two case reports of soft-tissue sarcoma. 3 , 4 We present a unique case of oral cavity squamous cell carcinoma (SCC) metastasizing to the ALT flap donor site. In addition, we review the existing literature, explore prevailing hypotheses, and discuss preventative measures to accentuate the clinical impact and raise awareness of this uncommon donor site complication.…”