This lady arrived at the hospital several days before I came. She was told that I was coming and might be able to help her. She was reported to have a recurrent Spindle cell tumor that has been operated on four times in the past-the last surgery being about 1.5 years ago. She has no evidence of metastatic disease so we decided to resect the tumor.
The surgery was quite dramatic. We had to remove all the skin that was involved, perform a radical neck, as well as remove the clavicle, the upper pectoralis major muscle, the deltoid muscle and part of the trapezius muscle. The capsule of the shoulder joint was completely exposed. We had a big hole! Using a somewhat radical solution to fill the hole, we mobilized the breast, removed most of the breast tissue and used the resulting skin as a cutaneous flap. In a few days we will cover the rest of the wound with a contralateral pectoralis flap. I hope this will be her last surgery.
|Specimen including deltoid and pectoralis|