Suspected Donor-Site Implantation of Floor of Mouth Squamous Cell Carcinoma After Free Flap Reconstruction: A Case Report.
TianWen Zhang, Bo Lin, HuiJun Yang et al.
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Case in brief
A 57-year-old man presented with a mass in the left floor of the mouth, diagnosed as squamous cell carcinoma (SCC). Following resection and reconstruction with a free flap, a mass developed in the left thigh scar five months post-surgery, which was found to be metastatic SCC. Additional tumors were identified on the right back and chest wall, leading to local recurrence and systemic metastases, resulting in the patient's death ten months after surgery.
What made this case unusual
The case highlights suspected donor-site implantation of SCC, potentially due to cross-contamination during surgical reconstruction, emphasizing the need for strict adherence to surgical principles.
Diagnostic / clinical pearl
Clinicians should be vigilant about the risk of tumor implantation at donor sites during free flap reconstructions and ensure meticulous surgical techniques to prevent cross-contamination.
Why it matters
This case underscores the importance of the 'no tumor left behind' principle in oncologic surgery, which is critical to prevent malignant tumor implantation and subsequent metastasis.