Polyakov A.P., Mordovskiy A.V., Miroshnichenko D.A., Rebrikova I.V., Ratushniy M.V., Boyko A.V., Gevorkov A.R., Buharov A.V., Derzhavin V.A., Kachmazov A.A. Implantation metastasis of Merkel cell carcinoma in a donor wound after surgical treatment with microsurgical reconstruction: a clinical case and a review. Head and neck. Russian Journal. 2022;10(4):53–61

Doi: 10.25792/HN.2022.10.4.53–61

Cases of iatrogenic dissemination of tumor cells during surgery were described as early as the end of the 19th century. Currently, a small number of cases of iatrogenic surgical contamination with malignant tumors in the form of implantation metastases are described in the world literature. This is probably due to the improvement of asepsis rules, the modification of surgical techniques, and the increased oncological alertness of medical personnel during surgery.
Clinical case. In the article, we describe a clinical case of surgical resection of skin cancer on the right side of external nose (Mercel cell carcinoma), with reconstruction with a radiation flap, at the site of which, 11 months after the operation, implantation metastasis was realized in the postoperative scar of the donor wound.
Currently, Merkel cell carcinoma is a poorly understood disease, especially its metastatic potential and aggressive growth pattern. Unfortunately, there are no uniform world standards, protocols, practical recommendations, and consensus among practicing surgeons regarding minimizing the potential risks of mechanical tumor implantation during oncological operations.
Key words: skin cancer, Merkel cell carcinoma, implantation metastasis, Merkel cell polyomavirus, iatrogenic transfer of tumor cells, microsurgical reconstruction, fasciocutaneous radiation flap, systemic metastases, radiation therapy, dissemination of tumor cells
Conflicts of interest. The authors have no conflicts of interest to declare.
Funding. There was no funding for this study

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