If not promptly or properly treated, certain cervical metastatic
cancers that develop from
unknown primary tumors may rapidly grow into giant
tumors that can invade the blood vessels, muscle and skin. The present study examined the feasibility and efficacy of
radical neck dissection combined with reconstruction using the pectoralis major
myocutaneous flap for the treatment of giant cervical metastatic
cancers that have developed from
unknown primary tumors and have invaded the skin. A total of 16 patients who met the inclusion criteria were subjected to
radical neck dissection to adequately resect invaded skin, and the pectoralis major
myocutaneous flap was used to repair the large skin defect created in the cervical region. Following the surgery, the patients received
concurrent chemoradiotherapy. The pectoralis major
myocutaneous flap survived in all 16 patients, with no cases of flap
necrosis. In addition, no post-operative
lymphedema,
paresthesia or dysfunction of an upper extremity occurred due to the cutting of a pectoralis major muscle. In 9 cases, patients were satisfied with their post-operative shoulder movement at the donor site; in the remaining 7 cases, patients felt greater weakness in this region following surgery relative to prior to surgery. The 14 male patients were generally satisfied with the post-operative appearance of the donor region, whereas the 2 female patients were dissatisfied with the appearance of this region. Follow-up for 6-53 months after the patients were discharged following surgery and
chemotherapy revealed that the recurrence of cervical
tumors in 6 cases. Overall,
radical neck dissection combined with the use of the pectoralis major
myocutaneous flap for reconstruction is a feasible approach for the treatment of giant cervical metastatic
cancers that have developed from
unknown primary tumors and have invaded the skin. Post-operative
concurrent chemoradiotherapy should be administered to improve the local control rate and patient quality of life, allowing a satisfactory therapeutic efficacy to be achieved.