title: Squamous cell carcinoma arising in the skin of a deltopectoral flap 27 years after pharyngeal reconstruction.
abstract: BACKGROUND
  Development of a second primary squamous cell carcinoma in the skin of a flap used for pharyngeal reconstruction is rare.
  
  
  METHODS
  A case of squamous cell carcinoma is presented arising in a deltopectoral flap used to reconstruct the hypopharynx 27 years after total laryngectomy. Three previous reports found on review of the literature are summarized.
  
  
  RESULTS
  A second primary squamous cell carcinoma may arise in the skin of a myocutaneous flap in the absence of any obvious risk factors.
  
  
  CONCLUSIONS
  We suspect that long-term exposure of the skin of the flap lining the pharynx to saliva may have been a significant factor in the development of this malignancy. Long-term follow up and awareness of this complication is required for patients with soft tissue reconstruction of the oral cavity and pharynx.
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Royal Melbourne Hospital, Grattan St., Parkville, Victoria, Australia 3052. iselitim@hotmail.com
authors.forename: Tim A
authors.initials: TA
authors.lastname: Iseli
authors.forename: Francis T
authors.initials: FT
authors.lastname: Hall
authors.forename: Malcolm R
authors.initials: MR
authors.lastname: Buchanan
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Kleid
mesh_terms: D000368:Aged; D002278:Carcinoma in Situ / Q000473:pathology*; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000601:surgery; D005500:Follow-Up Studies; D005931:Glottis; D006801:Humans; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000601:surgery; D007825:Laryngectomy / Q000379:methods; D008297:Male; D016609:Neoplasms, Second Primary / Q000473:pathology* / Q000601:surgery; D010369:Pectoralis Muscles / Q000473:pathology / Q000637:transplantation; D010610:Pharyngeal Neoplasms / Q000473:pathology* / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000379:methods; D012086:Reoperation; D018570:Risk Assessment; D013524:Surgical Flaps / Q000473:pathology*