From the Division of Orthopaedic Oncology (Dr. LiBrizzi, Dr. Rao, Dr. Levin, and Dr. Morris), Department of Orthopaedic Surgery, Department of Plastic and Reconstructive Surgery (Dr. Tuffaha), and the Department of Pathology (Dr. Gross), The Johns Hopkins University School of Medicine, Baltimore MD.
J Am Acad Orthop Surg Glob Res Rev. 2021 Dec 2;5(12):01979360-202112000-00005. doi: 10.5435/JAAOSGlobal-D-21-00208.
An 81-year-old woman with multiply recurrent undifferentiated pleomorphic sarcoma of the foot underwent wide excision and reconstruction with an anterolateral thigh free flap. Six years postoperatively, she developed biopsy-proven recurrence within the harvest site. No other sites of disease were detected on staging workup. The flap site recurrence was attributed to iatrogenic implantation at the time of harvesting. Iatrogenic metastases are thought to be caused by tumor implantation, which may be attributable to cross-contamination from instrumentation and surgical techniques. In the present article, we highlight preventive techniques and oncologic surgical principles intended to reduce the likelihood of iatrogenic metastasis. Increased awareness by all members of the surgical team may prevent this unfortunate complication.
一位 81 岁的女性患有多发复发性未分化多形性肉瘤，足部接受了广泛切除和前外侧股游离皮瓣重建。术后 6 年，在采集部位发现经活检证实的复发。分期检查未发现其他部位的疾病。皮瓣部位的复发归因于采集时的医源性种植。医源性转移被认为是由肿瘤种植引起的，这可能与器械和手术技术的交叉污染有关。在本文中，我们强调了旨在降低医源性转移可能性的预防技术和肿瘤外科原则。提高手术团队所有成员的认识可能会预防这种不幸的并发症。
