Rectus Abdominis Myocutaneous Flap for a Large Epigastric Soft Tissue Defect Following Resection of a Needle Tract Implanted Hepatocellular Carcinoma-A Case Report

A 58-year-old man with a diagnosis of hepatocellular carcinoma developed a palpable mass in his epigastric area. This mass was noted several months after a fine needle aspiration procedure for cytological diagnosis. En bloc excision of the 3.5cm cutaneous metastatic tumor was performed, but the epigastric defect was too large for primary closure. The abdominal rectus myocutaneous island pedicle flap was selected for reconstruction and mesh was utilized for repair donor site of the low abdominal wall. The wound healed properly and the patient did not experience any limitation of physical activity. Percutaneous needle biopsy of HCC should be performed carefully to avoid needle tract implantation. The abdominis rectus myocutaneous island pedicle flap seems to be an excellent choice in managing large abdominal wall defects in the epigastric area.