Anterior thigh myocutaneous flap for reconstruction after external hemipelvectomy performed to treat a buttock squamous cell carcinoma: case report

Abstract

Hemipelvectomy utilizing an anterior myocutaneous flap is indicted for extensive tumors of the buttock and posterior proximal portion of the thigh. A 49-year-old man came to the clinic with a tumor that had been progressively growing over three years. It was at the left buttock, and originated from an area of a previous scar and chronic ulceration. The tumor was infected and ulcerated, infiltrating to skin, subcutaneous fat, and gluteal musculature, being fixed to the iliac bone, hip joint and great trocanter. A CT-scan of the area showed infiltration of the structures above. An open biopsy was done and revealed a squamous cell carcinoma. External hemipelvectomy was the treatment option. A large defect was created after resection of the lower extremity, hemipelvis and buttock. An anterior myocutaneous flap of the quadriceps femoris, adductors, sartorius, pectineum and gracilis muscles with overlying subcutaneus fat and skin was done. The femoral vessels were used to mantain the flap viable. The post-operative course was uneventful and the flap remained fully viable. Some aspects of the technique are presented.