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MR imaging of recurrent head and neck tumours following flap reconstructive surgery
Noriaki Tomura1, Osamu Watanabe, Yoshinori Hirano
1Department of Radiology, Akita University School of Medicine, Akita City, Akita, Japan. tomura@med.akita-u.ac.jp
Aim:
The purpose of this study was to evaluate the magnetic resonance imaging (MRI) characteristics of recurrent tumours in patients who had undergone resection of primary head and neck tumours with flap reconstruction.
Materials And Methods:
MR examinations obtained from 25 patients who had undergone resection and flap reconstructive surgery for malignancy were analysed retrospectively. Tumour recurrence was confirmed by biopsy in 22 patients, and clinically in 3 patients. The features of the recurrent tumours in the scars were reviewed.
Results:
Twenty-one patients had a locally recurrent mass, while 4 had a locally recurrent mass in addition to regional lymph node metastases. Twenty-four of the recurrent tumours were localized in the recipient flap beds, near the anastomotic site. In 9 of 25 (36%) patients, the recurrent tumours extended intracranially, either directly, or through the foramina at the skull base.
Conclusion:
Tumour recurrence after flap reconstruction most often occurred at or near the anastomotic site. MRI is useful for detection of recurrence after flap reconstructive surgery in patients with head and neck cancer.