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Male papillary breast cancer treated by wide resection and latissimus dorsi flap reconstruction: A case report and review of the literature

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World Journal of Clinical Oncology 2016年第5期7卷 420-424页

作者： Malgorzata Banys-Paluchowski Eike Burandt Joanna Banys Stefan Geist Guido Sauter Natalia Krawczyk Peter Paluchowski Department of Obstetrics and Gynecology Marienkrankenhaus Hamburg Department of Pathology University of Hamburg Wroclaw Medical University Department of Obstetrics and Gynecology Regio Klinikum Pinneberg Department of Obstetrics and Gynecology University of Duesseldorf

Breast cancer(BC) in men represents between 0.5% and 1% of all BC diagnosed each year. We report a case of advanced BC in a 62-year-old male treated at our interdisciplinary Breast Cancer Center. The patient presented with a newly diagnosed large, symptomatic mass in his left breast. Clinical examination showed a not movable mass of 16 cm diameter, deforming the whole breast; the overlying skin was livid and hypervascularized. Enlarged lymph nodes were palpable in the axillary pit. He had no concomitant diseases at time of presentation. He denied any first- or second degree family medical history of cancer of any type and he never received radiotherapy. Ultrasound guided minimal-invasive 14-gauge core biopsy revealed a moderately differentiated encapsulated papillary carcinoma with high expression of estrogen and progesterone receptors(both > 80%, IRS 12) and HER2-negative. Because of the tumor size a mastectomy with axillary dissection and chest wall reconstruction using a latissimus dorsi flap was performed. Histological analysis showed invasive growth besides typical(non-invasive) papillary carcinoma and was classified as invasive solid papillary carcinoma; p T3(10 cm), p N0(0/15), M0,R0; Oncotype DX Recurrence Score indicated low risk(RS: 2). After discussion in the interdisciplinary tumor board meeting, radiation therapy and tamoxifen were recommended. The patient had an uneventful recovery and is disease-free after two years of follow-up. Male BC is typically diagnosed at an advanced stage, most likely due to a lack of awareness that men can develop BC. Therefore, in case of a large tumor, a flap-based thoracic reconstruction may be required.

关键词： Male breast cancer Papillary carcinoma Reconstruction Latissimus dorsi flap Rare tumors

Reverse latissimus dorsi muscle flap for complex back defects: our experience

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Plastic and Aesthetic Research 2017年第5期4卷 76-81页

作者： Kumaraswamy Mohan Kumar Shantha Kumar Shivalingappa Veena Prabhakar Waiker Udaya Shankar Odeyar Department of Plastic Surgery M.S.Ramaiah Medical CollegeBangalore 560054India

Aim: The aim was to study the effectiveness of the reverse latissimus dorsi muscle flap in reconstruction of complex defects of the back. Methods: This is a retrospective study of patients who underwent reverse latissimus dorsi flap for reconstruction of the back, in a tertiary care hospital. The patient demographics, etiology, surgery indications and complications were studied. Results: The study had five patients between 2012 and 2016 who underwent reverse latissimus dorsi flap for reconstruction. The flaps survived in all the patients. Two patients had complications, unrelated to the latissimus dorsi muscle flap. Conclusion: The vascularity of the flap is reliable can be used to obliterate the dead space, can be used to control the infection, in complex cases of the back.

关键词： Reverse latissimus dorsi muscle flap complex back defects reverse turn over flap

Reverse bilateral latissimus dorsi flap reconstruction after extensive mid back dermatofibrosarcoma protuberans excision:a case report

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Plastic and Aesthetic Research 2018年第3期5卷 1-8页

作者： Stefano Bonomi Laura Sala Alessandro Gronchi Dario Callegaro Umberto Cortinovis Plastic and Reconstructive Surgery Unit Fondazione IRCCS Istituto Nazionale dei TumoriVia Venezian 1Milan 20133Italy Sarcoma Surgery Unit Fondazione IRCCS Istituto Nazionale dei TumoriVia Venezian 1Milan 20133Italy

Surgical resection of soft tissue sarcoma of the trunk can result in large defects requiring complex reconstruction for coverage of vital neurovascular structures and tissue defect. Large defects of the back could be reconstructed with multiple random pattern or local pedicled flaps. We present the case of a 48-year-old patient with a locally advanced dermatofibrosarcoma protuberans of the back. Wide local excision of the lesion was performed. The soft tissue defect measured 22 cm × 20 cm × 4 cm and was reconstructed with bilateral reverse latissimus dorsi myocutaneous (RLDM) flap. Each RLDM flap measured 24 cm × 10 cm. The donor site on the back was closed directly on both sides. The patient recovered well and the two flaps healed uneventfully. Twelve months after surgery the patient is disease-free. The use of a RLDM flap in mid-back reconstructions provided wide well-vascularized soft tissue, minimized risk of infection, and maximized back coverage. This flap is an excellent choice for reconstruction of large defects of the mid-back.

关键词： Reverse latissimus dorsi myocutaneous flap trunk reconstruction posterior trunk defect sarcoma dermatofibrosarcoma protuberans

Defect reconstruction of the trochanter major after necrotizing fasciitis and multiple operations using an arteriovenous Ioop and Iatissimus dorsi free flap

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Plastic and Aesthetic Research 2018年第9期5卷 40-45页

作者： Andreas Arkudas Susanne Regus Alexander Meyer Werner Lang Marweh Schmitz Raymund E.Horch Department of Plastic and Hand Surgery University Hospital of ErlangenFriedrich-Alexander-University of Erlangen-Nürnberg(FAU)Erlangen 91054Germany Department of Vascular Surgery University Hospital of ErlangenFriedrich-Alexander-University of Erlangen-Nürnberg(FAU)Erlangen 91054Germany

Necrotizing fasciitis (NF) is a severe soft tissue infection which has to be treated with a radical debridement as the key element. In the further course often large tissue defects occur, so that a long-term stable defect reconstruction plays a crucial role after any successful debridement. The reconstruction can include split skin grafting or local and free flaps. Here we present a case of a 41-year-old male patient with a NF in the trochanter major region after spondylodesis and spinal cord stimulation (SCS) device implantation. After multiple operations including local and free flaps we performed a defect reconstruction using an arteriovenous (AV) loop and subsequent free latissimus dorsi transplantation leading to no further operations. This complex reconstruction can be considered as the final stage of any reconstruction latter.

关键词： Necrotizing fasciitis arteriovenous loop free Iatissimus dorsi flap transplantation

New model for cardiomyocyte sheet transplantation using a virus-cell fusion technique

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World Journal of Stem Cells 2015年第5期7卷 883-893页

作者： Yuto Takahashi Daihachiro Tomotsune Sakiko Takizawa Fengming Yue Mika Nagai Tadayuki Yokoyama Kanji Hirashima Katsunori Sasaki Department of Histology and Embryology Shinshu University School of Medicine Institute for Biomedical Sciences Interdisciplinary Cluster for Cutting Edge Research Shinshu University Bourbon Corporation Kashiwazaki Niigata 945-8611 Japan

AIM: To facilitate close contacts between transplanted cardiomyocytes and host skeletal muscle using cell fusion mediated by hemagglutinating virus of Japan envelope(HVJ-E) and tissue maceration. METHODS: Cardiomyocytes(1.5 × 106) from fetal rats were first cultured. After proliferation, some cells were used for fusion with adult muscle fibers using HVJ-E. Other cells were used to create cardiomyocyte sheets(area: about 3.5 cm2 including 2.1 × 106 cells), which were then treated with Nile blue, separated, and transplanted between the latissimus dorsi and intercostal muscles of adult rats with four combinations of HVJ-E and/or Na OH maceration: G1: HVJ-E(+), Na OH(+), Cardiomyocytes(+); G2: HVJ-E(-), NaO H(+), Cardiomyocytes(+); G3: HVJ-E(+),Na OH(-), Cardiomyocytes(+); G4: HVJ-E(-), Na OH(-), Cardiomyocytes(-). At 1 and 2 wk after transplantation, the four groups were compared by detection of beating domains, motion images using moving target analysis software, action potentials, gene expression of MLC-2v and Mesp1 by reverse transcription-polymerase chain reaction, hematoxylin-eosin staining, and immunostaining for cardiac troponin and skeletal ***: In vitro cardiomyocytes were fused with skeletal muscle fibers using HVJ-E. Cardiomyocyte sheets remained in the primary transplanted sites for 2 wk. Although beating domains were detected in G1, G2, and G3 rats, G1 rats prevailed in the number, size, motion image amplitudes, and action potential compared with G2 and G3 rats. Close contacts were only found in G1 rats. At 1 wk after transplantation, the cardiomyocyte sheets showed adhesion at various points to the myoblast layer in the latissimus dorsi muscle. At 2 wk after transplantation, close contacts were seen over a broad area. Part of the skeletal muscle sarcoplasma seemed to project into the myocardiocyte plasma and some nuclei appeared to share both ***: The present results show that close contacts were acquired and facilitated the

关键词： Cardiomyocyte sheet Latissimus dorsi Hemagglutinating virus of Japan envelope Cell fusion NaOH Maceration Cellular transplantation method

A New Method of Limb Salvage and Functional Upper Limb Reconstruction

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Modern Plastic Surgery 2012年第4期2卷 80-82页

作者： Ruka Shimizu Kazuo Kishi Hideo Morioka Hiroo Yabe Department of Orthopaedic Surgery Keio University School of Medicine Tokyo Japan Department of Plastic and Reconstructive Surgery Keio University School of Medicine Tokyo Japan

Amputation is frequently used to treat malignant tumors invading into the shoulder joint. When the vessels and major nerves of the upper arm are preserved, however, the limb may be salvaged with a combined osseous, myocutaneous flap. We reconstructed large defects, which included the shoulder joint, using a vascularized rib-latissmus dorsi combined flap. Ribs were connected via the ninth or tenth posterior intercostal artery. Several slits were cut in the ribs, and the rib was glass stick fractured to straighten it. The thoracodorsal nerve was preserved and the latissmus dorsi muscle was transferred to the defect previously occupied by the biceps humerus. The ribs were connected to the residual clavicle via a Leeds-Keio artificial ligament. The flaps completely engrafted. The patient was able to flex her elbow relatively early postoperatively. The function of the hand was preserved intact. In conclusion, the combined vascularized rib-latissmus dorsi flap is useful for patients who require functional or bony reconstruction of large defects involving the shoulder joint.

关键词： Shoulder Vascularized Rib Latissmus dorsi Elbow Flexion Limb Salvage