Metastases to the Donor Site of the Pectoralis Major Myocutaneous Flap Following Reconstructive Surgery: A Rare Complication

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

“…On followup after 6 months of treatment, there was clinico-radiologically complete response. Now he is on regular follow up for last 2 years Table 1 4,5,11,12,13,14 highlights other similar cases described in literature where oral cavity squamous cell carcinoma recurred over the anterior chest wall at PMMC donor site. The pattern of recurrence can be two types -one is metastases on PMMC vascular pedicle site 4,5,12 , which can be attributed mainly to lymphovascular spread of tumour cells occurring through the PMMC ap itself, and second is metastases over sites other than vascular pedicle site -either anterior chest wall 5,11,13 , or PMMC ap muscle 14 which can be due to direct transfer of tumour cells as contamination during surgery highlighting importance to change of gloves, thorough wash of surgical site and cleaning of instruments or to use a different set to avoid cross contamination during surgery.…”

Squamous Cell Carcinoma Metastasis to the Supraclavicular Artery Island Flap Donor Site

“…Hematogenous spread is another potential mechanism of metastasis to flap donor sites suggested by previous publications 9,10,13 . Circulating tumor cells are known to have an increased affinity for hypervascular environments, 9 such as those created by flap harvest and subsequent wound healing.…”

“…Hematogenous spread is another potential mechanism of metastasis to flap donor sites suggested by previous publications. 9,10,13 Circulating tumor cells are known to have an increased affinity for hypervascular environments, 9 such as those created by flap harvest and subsequent wound healing. Additionally, inflammation during surgery and postoperative healing has been shown to increase leukocyte penetration into tissue, 14 presumably increasing the risk of simultaneous tumor cell infiltration.…”

Case Reports of Two Unusual Donor Site Complications of the Pectoralis Major Myocutaneous Flap and Literature Review

“…Even the potential for direct cancer spillage to the PMMF donor site from the head and neck primary site has been reported. 5,26 Thus, all possible precautions should be taken to isolate the donor site from the recipient site. The chest donor site should be draped separately from the head and neck region because of the concern for contamination.…”