title: Combined Use of the Latissimus Dorsi Musculocutaneous Flap and the Anterolateral Thigh Flap to Reconstruct an Extensive Shoulder Defect in an NF-1 Patient.
abstract: Soft tissue coverage after the resection of a large malignant peripheral neural sheath tumor (MPNST) is a challenge. We report the successful reconstruction of an extensive shoulder defect after MPNST resection in a patient with a type 1 neurofibromatosis with a novel combination of flaps. A 70-year-old man with type 1 neurofibromatosis presented with a recurrent MPNST on his right shoulder. He underwent a wide excision of the tumor, which resulted in a huge soft tissue defect around the shoulder joint. The resultant defect was reconstructed with a pedicled latissimus dorsi musculocutaneous flap and a free anterolateral thigh flap. The flaps survived, and the wounds healed uneventfully. His affected arm was useful. The combination of a pedicled latissimus dorsi musculocutaneous flap and a free anterolateral thigh flap is a versatile option for the reconstruction of an extensive shoulder defect.
authors.affiliation: Divisions of Plastic and Reconstructive Surgery and Orthopedic Surgery, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Shimpei
authors.initials: S
authors.lastname: Miyamoto
authors.affiliation: Divisions of Plastic and Reconstructive Surgery and Orthopedic Surgery, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Masahide
authors.initials: M
authors.lastname: Fujiki
authors.affiliation: Divisions of Plastic and Reconstructive Surgery and Orthopedic Surgery, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Masanobu
authors.initials: M
authors.lastname: Sakisaka
authors.affiliation: Divisions of Plastic and Reconstructive Surgery and Orthopedic Surgery, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Kawai