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<p>Advanced sinonasal carcinoma often requires skull base surgery followed by skull base reconstruction. Free omental flaps with long vascular pedicles are sometimes used as reconstructive materials for this procedure. Currently, there have been no reported cases of lymph node metastasis in transplanted free omental flaps. Here, we report a rare case of olfactory neuroblastoma (ONB) metastasis to lymph node in the transplanted free omental. The patient is a 50-year-old man. Chemoradiotherapy was performed following a diagnosis of advanced ONB (Kadish Group C). The patient experienced repeated recurrences. After the seventh surgery the patient developed pneumocephalus and meningitis which required skull base surgery. Skull base reconstruction was performed using a free omental flap. Seven years later, enlarged lymph nodes in the transplanted free omental flap were observed and postoperative pathological diagnosis confirmed ONB metastasis. To detect local recurrence after skull base reconstruction surgery, careful observation is also required for lymph node metastasis within the transplanted tissue.</p>

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First Report of Lymph Node Metastasis in Free Omental Flap After Skullbase Surgery: A Case Report

  • 期刊论文

  • 发表日期：

    2025年8月4日

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  • Masashi Kuroki,
  • Hirofumi Shibata,
  • Hisakazu Kato,
  • Tatsuhiko Yamada,
  • Noriyuki Nakayama,
  • Yuta Sato,
  • Yoshihiro Tanaka,
  • Ryota Iinuma,
  • Hiroshi Okuda,
  • Kosuke Terazawa,
  • Keishi Kohyama,
  • Koki Ichihashi,
  • Natsuko Suzui,
  • Takenori Ogawa

摘要

Advanced sinonasal carcinoma often requires skull base surgery followed by skull base reconstruction. Free omental flaps with long vascular pedicles are sometimes used as reconstructive materials for this procedure. Currently, there have been no reported cases of lymph node metastasis in transplanted free omental flaps. Here, we report a rare case of olfactory neuroblastoma (ONB) metastasis to lymph node in the transplanted free omental. The patient is a 50-year-old man. Chemoradiotherapy was performed following a diagnosis of advanced ONB (Kadish Group C). The patient experienced repeated recurrences. After the seventh surgery the patient developed pneumocephalus and meningitis which required skull base surgery. Skull base reconstruction was performed using a free omental flap. Seven years later, enlarged lymph nodes in the transplanted free omental flap were observed and postoperative pathological diagnosis confirmed ONB metastasis. To detect local recurrence after skull base reconstruction surgery, careful observation is also required for lymph node metastasis within the transplanted tissue.