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Continued twitching of the latissimus dorsi miniflap after breast conservation therapy a case report.doc

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Continued twitching of the latissimus dorsi miniflap after breast conservation therapy a case report

Huangetal.WorldJournalofSurgicalOncology2012,10:122 /content/10/1/122 WORLD JOURNAL OF SURGICAL ONCOLOGY CASE REPORT OpenAccess Continuedtwitchingofthelatissimusdorsi miniflapafterbreastconservationtherapy:acase report Du-PingHuang ,Xiao-HeYe ,You-qunXiang andXiao-HuaZhang1* 1 2 1* Abstract Wereportacaseofcontinuedtwitchingofthelatissimusdorsimusclefollowingbreastconservationtherapy,along withimmediatereconstructionwithalatissimusdorsiminiflap,whichcontinueddespiteseveralattemptsatcontrol includingBTX-Apercutaneouslocalinjection,andwasfinallycuredbydelayeddivisionofthethoracodorsalnerve viaasmallwell-toleratedaxillaryincision. Keywords:Breastcancer,Breastconservationtherapy,Muscletwitching Background which soon became persistent. The patient with this A 46-year-old woman was admitted with the complaint condition saw a disturbing superolateral movement of ofaleftbreastlumpthatwasnoticed10dayspreviously. the transferred muscle (receptor area), but it was well On physical examination, there was a palpable mass tolerated and did not interfere with sleep although her measuring about 2.0 cm in the upper inner quadrant of husbandnoticedthatitstilloccurredthen.Itwasworse the left breast. Axillary lymph nodes were not palpable. whentheupperarmwasextended.Astheproblemcon- Abreastconservationtherapy,alongwithimmediatere- tinued she was referred to the neurology clinic. At the construction with a latissimus dorsi miniflap was per- neurology clinic, electromyogram studies showed that formed on the left side in Oct 2005. Tumor excision, the abnormal, voluntary muscle twitching was confined axillarynodalclearance,andlatissimusdorsiminiflapre- to the latissimus dorsi muscle only and did not involve construction were performed as a one-stage technique any other adjacent muscles. She was treated with anti- oncecleartumormarginswereconfirmedbyfrozensec- spasmodicsandanti-epileptiformdrugswithoutsuccess, tion. Subsequentparaffinsection alsoconfirmed tumor-