Abstract：
BACKGROUND: Salvage surgery with reconstruction of the second and next primary tongue cancer remains difficult, especially after earlier neck dissection and radiotherapy. In the current report, we describe the feasibility of the extended, double-pedicled facial artery musculomucosal (dpFAMM) flap in the reconstruction of the patient with second primary tongue squamous cell carcinoma, after facial vessel ligation and radiotherapy.
METHODS: An 81-year-old female patient was operated on due to tongue squamous cell carcinoma (SCC) on the left side T3N1M0 in 2019. Bilateral selective neck dissection with tongue reconstruction was performed by island FAMM flap. The patient also suffered from synchronous mucinous breast carcinoma treated with tamoxifen. The second primary SCC of the tongue on the opposite (right) side was detected in 2020. The patient did not agree to surgical treatment; therefore, radiotherapy was performed. The local recurrence of the tongue cancer of the right side was treated surgically in 2021. Salvage surgery comprised hemiglossectomy and dpFAMM flap reconstruction with uneventful postoperative follow-up.
CONCLUSIONS: This case presentation proved that dpFAMM flap can be used in salvage surgery and reconstruction even in patients after ligation of facial vessels, irradiation, and in the course of hormone therapy. The flap is easy to handle, has good vascularity, and comprises a predictable method of reconstruction, especially for patients with severe comorbidities.
METHODS: An 81-year-old female patient was operated on due to tongue squamous cell carcinoma (SCC) on the left side T3N1M0 in 2019. Bilateral selective neck dissection with tongue reconstruction was performed by island FAMM flap. The patient also suffered from synchronous mucinous breast carcinoma treated with tamoxifen. The second primary SCC of the tongue on the opposite (right) side was detected in 2020. The patient did not agree to surgical treatment; therefore, radiotherapy was performed. The local recurrence of the tongue cancer of the right side was treated surgically in 2021. Salvage surgery comprised hemiglossectomy and dpFAMM flap reconstruction with uneventful postoperative follow-up.
CONCLUSIONS: This case presentation proved that dpFAMM flap can be used in salvage surgery and reconstruction even in patients after ligation of facial vessels, irradiation, and in the course of hormone therapy. The flap is easy to handle, has good vascularity, and comprises a predictable method of reconstruction, especially for patients with severe comorbidities.
摘要：
背景：重建第二和下一个原发性舌癌的挽救手术仍然很困难，特别是在早期的颈部清扫和放疗后。在当前的报告中,我们描述了扩展的可行性，双蒂面动脉肌粘膜（dpFAMM）皮瓣在第二原发性舌鳞状细胞癌患者的重建中，面部血管结扎和放疗后。
方法：2019年，一名81岁女性患者因左侧T3N1M0舌鳞状细胞癌（SCC）进行手术。通过岛状FAMM皮瓣进行双侧选择性颈夹层和舌重建。该患者还患有用他莫昔芬治疗的同步粘液性乳腺癌。在2020年检测到相反（右侧）的舌头的第二个主要SCC。患者不同意手术治疗；因此，进行放疗。2021年手术治疗右侧舌癌局部复发。挽救手术包括半甲状腺切除术和dpFAMM皮瓣重建，术后随访顺利。
结论：本病例证明dpFAMM皮瓣可用于面部血管结扎后的抢救手术和重建，辐照，在激素治疗过程中。皮瓣很容易处理，有很好的血管分布，并且包括一种可预测的重建方法，特别是对于有严重合并症的患者。
方法：2019年，一名81岁女性患者因左侧T3N1M0舌鳞状细胞癌（SCC）进行手术。通过岛状FAMM皮瓣进行双侧选择性颈夹层和舌重建。该患者还患有用他莫昔芬治疗的同步粘液性乳腺癌。在2020年检测到相反（右侧）的舌头的第二个主要SCC。患者不同意手术治疗；因此，进行放疗。2021年手术治疗右侧舌癌局部复发。挽救手术包括半甲状腺切除术和dpFAMM皮瓣重建，术后随访顺利。
结论：本病例证明dpFAMM皮瓣可用于面部血管结扎后的抢救手术和重建，辐照，在激素治疗过程中。皮瓣很容易处理，有很好的血管分布，并且包括一种可预测的重建方法，特别是对于有严重合并症的患者。
