title: Use of a tissue expander as a radio-protective spacer with a latissimus dorsi flap in the management of a peripheral primitive neuroectodermal tumour (pPNET).
abstract: Peripheral primitive neuroectodermal tumours (pPNET) are aggressive neoplasms that require radical surgical resection with adjuvant chemotherapy and radiotherapy. A pPNET of the posterior chest wall was resected with wide soft tissue margins in a 14 year old male. Following tumour excision a spacer device was positioned in the retroperitoneum adjacent to the ipsilateral left kidney displacing it from the planned radiotherapy field. A pedicled latissimus dorsi myocutaneous flap was used to achieve robust soft tissue cover. Ultrasound demonstrated anteromedial displacement of the left kidney with no hydronephrosis and renal function remained normal during subsequent radiotherapy. This report highlights the usefulness of a tissue expander in providing protection for vital structures during radiotherapy.
authors.affiliation: Department of Plastic & Reconstructive Surgery, Alder Hey Children's Hospital NHS Foundation Trust, Eaton Road, Liverpool L12 2AP, United Kingdom. fateh3@tiscali.co.uk
authors.forename: F
authors.initials: F
authors.lastname: Ahmad
authors.forename: J S
authors.initials: JS
authors.lastname: Suominen
authors.forename: Z
authors.initials: Z
authors.lastname: Hassan
authors.forename: B L
authors.initials: BL
authors.lastname: Pizer
authors.forename: C
authors.initials: C
authors.lastname: Duncan
authors.forename: P D
authors.initials: PD
authors.lastname: Losty
mesh_terms: D000293:Adolescent; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging*; D008297:Male; D018241:Neuroectodermal Tumors, Primitive, Peripheral / Q000532:radiotherapy*; D013524:Surgical Flaps; D035441:Thoracic Wall / Q000473:pathology / Q000601:surgery*; D015625:Tissue Expansion Devices; D014463:Ultrasonography