Trapezius Rotational Flap for Cervico-thoracic Wound Breakdown in Post-radiotherapy Necrosis: A Case Report

The management of post-radiation wound breakdown over the posterior cervico thoracic region can be a challenging task for a surgeon. The aim of the treatment is to produce a well vascularized and a low tensile flap which will close a large defect. We describe the use of the lower trapezius flap to reconstruct the wound breakdown and to obtain stable tissue coverage in a patient with postradiation necrosis. This flap minimizes the disruption of the scapula-thoracic function while preserving the range of movement over the shoulder. From the literature review, it was noted that the dorsal scapular artery (DSA) and transverse cervical artery (TCA) aid in the blood supply to the trapezius muscle and prevent local necrosis during rotation of the flap. The trapezius flap is widely accepted because of the minor donor site morbidity, large arc of rotation and adequate blood supply.

Castleman's disease in association with follicular dendritic cell sarcoma presenting as a neck mass

Castleman's disease is a condition which usually occurs in the mediasternum. Very few cases have been reported to present as a neck swelling. Castleman's disease is rarely associated with follicular dendritic sarcoma. We report a case of 65 years old male with painless and slowly progressive right neck swelling who was initially suspected to be schwannoma but proved to be a Castleman's disease with associated follicular dendritic sarcoma