Bae Seong Hwan, Lee Yong Woo, Nam Su Bong, Lee So Jeong, Park Heeseung, Kang Taewoo
Department of Plastic and Reconstructive Surgery, Pusan National University School of Medicine, Busan, Korea.
Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.
Arch Plast Surg. 2020 May;47(3):267-271. doi: 10.5999/aps.2019.00402. Epub 2020 Apr 10.
The latissimus dorsi musculocutaneous flap (LDMCF) is widely used for breast reconstruction. However, it has the disadvantage of frequent seroma formation at the donor site, and late seroma has also been reported. The authors report histological findings after the surgical treatment of a late, repeatedly recurrent seroma at 10 years after breast reconstruction with LDMCF. In 2008, a 66-year-old female patient underwent immediate breast reconstruction with LDMCF. In 2015, a late seroma was found at the donor site. After aspiration and drainage, the seroma recurred again in 2018. Total surgical excision of the seroma was performed and bloody-appearing fluid was identified in the capsule. The excised tissue was biopsied. Histological examination revealed no evidence of blood in the fluid, and multinucleated giant cells with amorphous eosinophilic proteinaceous material were identified. The cyst was suggestive of chronic granulomatous inflammation. There was no recurrence at 8 months postoperatively. The patient described herein underwent surgical treatment of late seroma that recurred after immediate breast reconstruction with LDMCF, and histological findings were identified. These results may be helpful for other future studies regarding late seroma after breast reconstruction with LDMCF.
背阔肌肌皮瓣（LDMCF）广泛应用于乳房重建。然而，它存在供区频繁形成血清肿的缺点，并且也有晚期血清肿的报道。作者报告了1例在采用LDMCF进行乳房重建10年后出现的晚期、反复复发血清肿手术治疗后的组织学结果。2008年，一名66岁女性患者接受了LDMCF即刻乳房重建。2015年，在供区发现了晚期血清肿。抽吸引流后，血清肿在2018年再次复发。对血清肿进行了彻底手术切除，在囊内发现了血性液体。对切除的组织进行了活检。组织学检查显示液体中无血液证据，并发现了含有无定形嗜酸性蛋白质物质的多核巨细胞。该囊肿提示为慢性肉芽肿性炎症。术后8个月无复发。本文所述患者接受了LDMCF即刻乳房重建后复发的晚期血清肿的手术治疗，并确定了组织学结果。这些结果可能有助于未来其他关于LDMCF乳房重建后晚期血清肿的研究。
