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The Reconstruction after a Giant Phyllodes Tumor Resection Using a DIEP Flap
Yuki Tsuruta1, Ryo Karakawa1, Koya Majima1
1Department of Plastic and Reconstructive Surgery, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan.
Plastic and Reconstructive Surgery. Global Open
|May 23, 2020
Summary
Giant phyllodes tumors of the breast require extensive reconstruction. A deep inferior epigastric artery perforator (DIEP) flap successfully reconstructed a massive defect after removing a 4,230g tumor, offering a viable autologous tissue option.
Area of Science:
- Plastic Surgery
- Surgical Oncology
- Breast Surgery
Background:
- Phyllodes tumors of the breast are rare, aggressive neoplasms that can grow to enormous sizes.
- Complete surgical resection is the standard treatment, often resulting in large tissue defects.
- Reconstruction of significant post-excision defects presents a considerable surgical challenge.
Observation:
- A 48-year-old woman presented with a giant phyllodes tumor requiring a 22 × 24 cm skin defect after resection.
- A deep inferior epigastric artery perforator (DIEP) flap was utilized for immediate breast reconstruction.
- The flap was successfully anastomosed to the internal mammary and lateral thoracic vessels, with complete flap survival.
Findings:
- The resected phyllodes tumor specimen weighed an unprecedented 4,230g.
- The DIEP flap provided ample autologous tissue for reconstruction without muscle sacrifice.
- This represents, to our knowledge, the largest phyllodes tumor reconstruction using autologous tissue.
Implications:
- Deep inferior epigastric artery perforator (DIEP) flap reconstruction is a feasible and effective option for massive breast defects following giant phyllodes tumor excision.
- This technique offers a valuable alternative to other reconstructive methods, preserving donor site function and achieving aesthetic outcomes.
- Further research and long-term follow-up are warranted to solidify the role of DIEP flaps in managing these rare and extensive breast tumors.
