Squamous cell carcinoma arising on a forearm free flap 21 years after hemiglossectomy


COD: 2468_04_02_2016_ep Categorie: , ,

Valentino Valentini, Andrea Cassoni, Valentina Terenzi, Gianmarco Prucher, Oriana Rajabtork Zadeh, Sandro Bosco, Evaristo Belli

Ann. Ital. Chir.Published online (EP) 4 February 2016

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AIM: Free and pedicled flap are methods of choice for reconstruction of post-surgical defects consequent to oral squamouscell carcinomas (SCCs), and missing intraoral mucosa is commonly reconstructed by the cutaneous component of the flapto guarantee an epithelial lining. Even if rare, cases of second tumors arising in the skin flap have been described. Wepresent our experience reporting a clinical case.
CASE REPORT: A squamous cell carcinoma arose on a forearm free flap 21 years after hemiglossectomy in a 72 years oldwoman. No smoking or alcohol habits were referred, and it was decided to perform surgical resection of the flap. RESULTS: Resection in free margins of a moderate differentiated (G2) SCC staged as pT2 was achieved and reconstruc-tion with anterolateral thigh free flap was performed.
DISCUSSION: Even if rare, secondary tumors arising in the skin flap in case of oral cavity defects reconstruction aredescribed. It is important to recognize them early in order to perform surgical resection.
CONCLUSION: We think that it is fundamental to perform a prolonged follow-up of skin flap if a white patch or ery-thema raising clinical suspicion are present. Incisional biopsy has to be performed in order to identify those lesions poten-tially inclined to a malignant transformation, such as p53 expression and Ki67 index.