Squamous cell carcinoma arising in the skin of a deltopectoral flap 27 years after pharyngeal reconstruction

Background Development of a second primary squamous cell carcinoma in the skin of a flap used for pharyngeal reconstruction is rare. Methods A case of squamous cell carcinoma is presented arising in a deltopectoral flap used to reconstruct the hypopharynx 27 years after total laryngectomy. Three previous reports found on review of the literature are summarized. Results A second primary squamous cell carcinoma may arise in the skin of a myocutaneous flap in the absence of any obvious risk factors. Conclusion We suspect that long‐term exposure of the skin of the flap lining the pharynx to saliva may have been a significant factor in the development of this malignancy. Long‐term follow up and awareness of this complication is required for patients with soft tissue reconstruction of the oral cavity and pharynx. © 2002 John Wiley & Sons, Inc. Head Neck 24: 87–90, 2002.