title: Reconstruction with a pectoralis major myocutaneous flap after left first rib and clavicular chest wall resection for a metastasis from laryngeal cancer.
abstract: We presented a case of recurrent metastasis from epidermoid cancer that occurred in the left clavicle of a patient with a history of laryngeal cancer treated on April 2005 with extended hemilaryngectomy, neck dissection and chemoradiation therapy. On September 2008, he developed a left clavicular metastasis. The disease was initially well controlled by chemoradiotherapy but it recurred 17 months later. The optimal treatment plan was established by several multidisciplinary meetings and the patient subsequently underwent an en bloc resection of the left clavicle, first rib and all the other involved structures. Coverage of the thoracic defect was achieved using pectoralis major myocutaneous flap. The patient had a successful surgical outcome. At 1-year follow-up, he had no evidence of disease, a good cosmetic result and returned to normal daily activity. He died for bone metastasis with an overall 21 months post-surgical survival.
authors.affiliation: Istituto Oncologico del Mediterraneo, 7 Via Penninazzo, 95029, Viagrande, Catania, Italy.
authors.forename: Francesco Paolo
authors.initials: FP
authors.lastname: Caronia
authors.affiliation: Thoracic Surgery Unit, Second University of Naples, Piazza Miraglia 3, 80138, Naples, Italy. alfonso.fiorelli@unina2.it.
authors.forename: Alfonso
authors.initials: A
authors.lastname: Fiorelli
authors.affiliation: Orthopedic Unit, Second University of Naples, 80138, Naples, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Zanchini
authors.affiliation: Thoracic Surgery Unit, Second University of Naples, Piazza Miraglia 3, 80138, Naples, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Santini
authors.affiliation: Department of General Surgery, University of Palermo, 129 Via del Vespro, 90127, Palermo, Italy.
authors.forename: Attilio Ignazio
authors.initials: AI
authors.lastname: Lo Monte
authors.affiliation: G.B. Morgagni Foundation, Department of Bio-Medical Sciences, University of Catania, Catania, Italy.
authors.forename: Sergio
authors.initials: S
authors.lastname: Castorina
mesh_terms: D001859:Bone Neoplasms / Q000556:secondary / Q000601:surgery*; D002294:Carcinoma, Squamous Cell / Q000556:secondary / Q000601:surgery*; D002968:Clavicle / Q000601:surgery; D006801:Humans; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D064827:Myocutaneous Flap; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local / Q000556:secondary / Q000601:surgery*; D019651:Plastic Surgery Procedures; D012272:Ribs / Q000601:surgery; D035441:Thoracic Wall / Q000601:surgery; D013905:Thoracoplasty
keywords: Chest wall involvement; Chest wall reconstruction; Clavicular resection; Laryngeal cancer; Muscle flap