CT and MR appearance of recurrent malignant head and neck neoplasms after resection and flap reconstruction.
OBJECTIVE
To describe the appearance of recurrent malignant neoplasms in patients who have undergone resection of primary head and neck tumors with flap reconstruction.


METHODS
Thirty-two examinations, 26 CT and 6 MR scans, were retrospectively reviewed in 25 patients with documented recurrent malignant neoplasms. Confirmation of disease was by biopsy or disease progression. The flaps included 15 myocutaneous, 6 free composite, 2 jejunal free grafts, and 2 combined jejunal and myocutaneous flaps.


RESULTS
The most common location of recurrence was in the primary tumor bed involving the undersurface or suture line of the reconstruction flaps, 14 of 32 scans; both nodal and flap recurrence was seen in 12 of 32 scans.


CONCLUSIONS
When examining patients who may have recurrent disease after flap reconstruction, the radiologist should be aware of the type of flap used and the expected appearance. Tumor recurrence in this patient population is manifest either as a focal recurrent mass at or near the suture line of the reconstruction flap, or nodal disease, usually in the contralateral neck.
Department of Radiology, Emory University School of Medicine, Atlanta, GA 30322.
P A
PA
Hudgins
J G
JG
Burson
G S
GS
Gussack
W J
WJ
Grist
D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D003937:Diagnosis, Differential; D005260:Female; D006258:Head and Neck Neoplasms / Q000175:diagnosis* / Q000532:radiotherapy / Q000601:surgery; D006801:Humans; D008207:Lymphatic Metastasis; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000532:radiotherapy / Q000601:surgery; D009959:Oropharyngeal Neoplasms / Q000175:diagnosis / Q000532:radiotherapy / Q000601:surgery; D011183:Postoperative Complications / Q000175:diagnosis* / Q000601:surgery; D012086:Reoperation; D012189:Retrospective Studies; D013524:Surgical Flaps; D013536:Suture Techniques; D014057:Tomography, X-Ray Computed