Pedicled latissimus dorsi flap and internal mammary perforator flaps for coverage of the latero-cervico-thoracic area after soft-tissue sarcoma resection: A case report

Soft tissue sarcomas are rare tumors requiring wide surgical excision to ensure local control. When located in complex anatomical areas such as the cervico-thoracic junction, these resections can involve vital structures that require immediate and reliable reconstruction. We report the case of a 63-year-old woman with a large radiation-induced sarcoma involving the right cervico-thoracic region. A wide excision was performed by a multidisciplinary team, followed by immediate reconstruction using a pedicled latissimus dorsi flap (LD) and an internal mammary artery perforator (IMAP) flap. These two flaps provided effective coverage of the exposed vital structures and allowed early initiation of adjuvant chemoradiotherapy. This clinical case illustrates how the involvement of a plastic surgeon within a multidisciplinary team facilitates extended resections of soft tissue sarcomas involving critical structures, which would otherwise be unresectable without reconstruction.