[Fillet flap for axillary reconstruction]

Among all complications that affect patients with neurofibromatosis, type I (NF1) are very aggressive malignant nerve sheath tumors (MPNSTs). Surgery is their first line therapy.

We report the case of a non metastatic neurofibrosarcoma of the axillary area in a 22-year-old male with NF1. An interscapulothoracic resection was performed to resect the tumor and had sacrificed the homolateral latissimus dorsi pedicled myocutaneous flap. In this extreme and not codified situation, the coverage of the tissue loss was possible in the same time using a free flap harvested on the amputated limb (fillet flap). The free flap based on the humeral pedicle was composed of the entire skin and muscles of the amputated forearm. It was anastomosed on the subclavian vessels. Only a free flap was suitable in this tissue loss. The use of a fillet flap allows a wide and reliable coverage without donor site morbidity.