LYMPHOSCINTIGRAPHY IN PECTORALIS MAJOR MYOCUTANEOUS FLAPS

Myocutaneous flaps are used widely in the surgical treatment of advanc ed cancers, which in the past had been thought to be inoperable. Tumor recurrences are expected more frequently in these patients. Recurrent tumors may spread locally and to the regional areas via lymphatics an d vessels. However, the lymphatic spread may differ in cases where myo cutaneous flaps are used for reconstruction. This study is based on fi ve patients with head and neck cancer who underwent reconstruction wit h myocutaneous naps. Technetium Tc99m-labeled dextran was used to demo nstrate the lymphatic flow, and technetium Tc99m rhenium sulfur colloi d was used to show the lymph nodes of the neck and pectoralis major my ocutaneous flap. Our findings show that the newly formed lymphatics do not pierce the fibrotic border of the donor and recipient sides. Lymp hatic metastasis may occur to the internal mammary nodes through the m yocutaneous flap only after recurrent tumors have invaded the myocutan eous flap directly.