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Eguchi K, Kobayashi K, Honma Y, Ryo E, Sakyo A, Yokoyama K, Watanabe T, Aihara Y, Sakai A, Matsumoto Y, Sakai T, Omura G, Yatabe Y, Yoshimoto S, Mori T. Clinical and pathological features of second primary neoplasms arising in head and neck reconstructive skin flaps. Sci Rep 2023; 13:11214. [PMID: 37433786 DOI: 10.1038/s41598-023-38122-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 07/03/2023] [Indexed: 07/13/2023] Open
Abstract
The incidence of second primary neoplasms arising in the skin reconstructive flap (SNAF) is increasing because of the increase in head and neck flap reconstruction and cancer survival. Prognosis, optimal treatment, and their clinicopathological-genetic features are under debate and are difficult to diagnose. We retrospectively reviewed SNAFs based on a single center's experience over 20 years. Medical records and specimens of 21 patients with SNAF who underwent biopsies between April 2000 and April 2020 at our institute were retrospectively analyzed. Definite squamous cell carcinoma and the remaining neoplastic lesions were subclassified as flap cancer (FC) and precancerous lesions (PLs), respectively. Immunohistochemical studies focused on p53 and p16. TP53 sequencing was conducted using next-generation sequencing. Seven and 14 patients had definite FC and PL, respectively. The mean number of biopsies/latency intervals was 2.0 times/114 months and 2.5 times/108 months for FC and PL, respectively. All lesions were grossly exophytic and accompanied by inflamed stroma. In FC and PL, the incidences of altered p53 types were 43% and 29%, respectively, and those of positive p16 stains were 57% and 64%, respectively. Mutation of TP53 in FC and PL were 17% and 29%, respectively. All except one patient with FC under long-term immunosuppressive therapy survived in this study. SNAFs are grossly exophytic tumors with an inflammatory background and show a relatively low altered p53 and TP53 rate and a high p16 positivity rate. They are slow-growing neoplasms with good prognoses. Diagnosis is often difficult; therefore, repeated or excisional biopsy of the lesion may be desirable.
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Affiliation(s)
- Kohtaro Eguchi
- Department of Head and Neck Surgery, National Cancer Center Hospital, 5-1-1, Chuo-ku, Tokyo, 104-0045, Japan
| | - Kenya Kobayashi
- Department of Head and Neck Surgery, National Cancer Center Hospital, 5-1-1, Chuo-ku, Tokyo, 104-0045, Japan
- Department of Otolaryngology, Head and Neck Surgery, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Yoshitaka Honma
- Department of Head and Neck, Esophageal Medical Oncology, National Cancer Center Hospital, 5-1-1, Chuo-ku, Tokyo, 104-0045, Japan
| | - Eijitsu Ryo
- Department of Head and Neck, Esophageal Medical Oncology, National Cancer Center Hospital, 5-1-1, Chuo-ku, Tokyo, 104-0045, Japan
- Division of Molecular Pathology, National Cancer Center Research Institute, 5-1-1, Chuo-ku, Tokyo, 104-0045, Japan
| | - Airi Sakyo
- Department of Diagnostic Pathology, National Cancer Center Hospital, 5-1-1, Chuo-ku, Tokyo, 104-0045, Japan
| | - Kazuki Yokoyama
- Department of Head and Neck, Esophageal Medical Oncology, National Cancer Center Hospital, 5-1-1, Chuo-ku, Tokyo, 104-0045, Japan
| | - Takane Watanabe
- Department of Head and Neck Surgery, National Cancer Center Hospital, 5-1-1, Chuo-ku, Tokyo, 104-0045, Japan
| | - Yusuke Aihara
- Department of Head and Neck Surgery, National Cancer Center Hospital, 5-1-1, Chuo-ku, Tokyo, 104-0045, Japan
| | - Azusa Sakai
- Department of Head and Neck Surgery, National Cancer Center Hospital, 5-1-1, Chuo-ku, Tokyo, 104-0045, Japan
| | - Yoshifumi Matsumoto
- Department of Head and Neck Surgery, National Cancer Center Hospital, 5-1-1, Chuo-ku, Tokyo, 104-0045, Japan
| | - Toshihiko Sakai
- Department of Head and Neck Surgery, National Cancer Center Hospital, 5-1-1, Chuo-ku, Tokyo, 104-0045, Japan
| | - Go Omura
- Department of Head and Neck Surgery, National Cancer Center Hospital, 5-1-1, Chuo-ku, Tokyo, 104-0045, Japan
| | - Yasushi Yatabe
- Department of Diagnostic Pathology, National Cancer Center Hospital, 5-1-1, Chuo-ku, Tokyo, 104-0045, Japan
- Division of Molecular Pathology, National Cancer Center Research Institute, 5-1-1, Chuo-ku, Tokyo, 104-0045, Japan
| | - Seiichi Yoshimoto
- Department of Head and Neck Surgery, National Cancer Center Hospital, 5-1-1, Chuo-ku, Tokyo, 104-0045, Japan
| | - Taisuke Mori
- Department of Diagnostic Pathology, National Cancer Center Hospital, 5-1-1, Chuo-ku, Tokyo, 104-0045, Japan.
- Division of Molecular Pathology, National Cancer Center Research Institute, 5-1-1, Chuo-ku, Tokyo, 104-0045, Japan.
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Di Taranto G, Elia R, Pafitanis G, Amorosi V, Liao LY, Chen SH, Chen HC. Late occurrence of squamous cell carcinoma arising from skin-lining flap. Microsurgery 2018; 39:96-97. [PMID: 30508320 DOI: 10.1002/micr.30400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Revised: 09/15/2018] [Accepted: 10/24/2018] [Indexed: 11/10/2022]
Affiliation(s)
- G Di Taranto
- Department of Plastic Surgery, China Medical University Hospital, Taichung, Taiwan.,Department of Plastic and Reconstructive Surgery, Sapienza University of Rome, Umberto I University Hospital, Rome, Italy
| | - R Elia
- Department of Plastic Surgery, China Medical University Hospital, Taichung, Taiwan.,Division of Plastic and Reconstructive Surgery, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
| | - G Pafitanis
- Department of Plastic Surgery, China Medical University Hospital, Taichung, Taiwan.,Group for Academic Plastic Surgery, Queen Mary University of London, The Royal London Hospital, Barts Health NHS Trust, London, United Kingdom
| | - V Amorosi
- Department of Plastic Surgery, China Medical University Hospital, Taichung, Taiwan.,Plastic Surgery Unit, Sant'Andrea Hospital, School of Medicine and Psychology, "Sapienza" Rome, Rome, Italy
| | - L Y Liao
- Department of Plastic Surgery, China Medical University Hospital, Taichung, Taiwan.,Department of Plastic Surgery, Chang Gung Memorial Hospital, Taiwan
| | - S-H Chen
- Department of Plastic Surgery, China Medical University Hospital, Taichung, Taiwan.,Department of Plastic Surgery, Chang Gung Memorial Hospital, Taiwan
| | - Hung-Chi Chen
- Department of Plastic Surgery, China Medical University Hospital, Taichung, Taiwan
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Rahpeyma A, Khajehahmadi S. Pathologic Surface Changes in the Submental Flap Used for Intraoral Reconstruction: Report of Two Cases. J Clin Diagn Res 2015; 9:ZD01-3. [PMID: 26436060 PMCID: PMC4576654 DOI: 10.7860/jcdr/2015/12269.6267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Accepted: 05/25/2015] [Indexed: 11/24/2022]
Abstract
Soft tissue reconstruction is often necessary after pathologic resection of oral squamous cell carcinoma. Although morphologic changes are common after transfer of the flaps to the oral cavity, pathologic changes within the transferred flaps, used for intraoral reconstruction, are rare events. Despite the widespread use of submental flap for oral cavity reconstruction, there are no reports in this respect. In this article, pathologic changes in the surface epithelium of transferred submental flaps are demonstrated with the report of two cases. The occurrence of lichen planus in a submental flap that had been used for reconstruction of lateral tongue border is reported in one case and in another patient, squamous cell carcinoma arising in the transferred de-epithelialized submental flap, used for maxillary and buccal reconstruction, is shown.
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Affiliation(s)
- Amin Rahpeyma
- Associate Professor, Department of Oral and Maxillofacial Surgery, Oral and Maxillofacial Diseases Research Center, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Saeedeh Khajehahmadi
- Assistant Professor, Department of Oral and Maxillofacial Pathology, Dental Research Center, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
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