Squamous cell carcinoma derived from a skin flap used for reconstruction of the hypopharynx

Development of a secondary primary cancer in a skin flap is a rare complication. A 70-year-old man underwent partial laryngopharyngectomy, right neck dissection and reconstruction with a radial forearm free flap in 2004. Five years later, an exophytic tumor was found on the hypopharynx reconstructed with the radial forearm free flap. He underwent total laryngopharyngectomy, left neck dissection and reconstruction with a jejunal free flap in June 2009. Pathological findings suggested this was a primary cancer rather than a metastasis. Localization to the epidermis and dermis indicate that the tumor was derived from the surface of the skin flap.