Reconstruction of an extended defect in the axilla using a thoracodorsal fasciocutaneous perforator flap

Background: Ectopic primary carcinoma of breast tissue is a rare entity, and its diagnosis often is delayed. The axilla is the most common site involved. The Limberg flap as a random flap is easy and practicable for coverage of many defects including those involving the axilla. In the reported case, the vascularity of the flap was improved by including a thoracodorsal artery perforator. Methods: This report presents the clinical features of a case of ectopic breast carcinoma in the axilla and an alternative tension-free Limberg thoracodorsal artery perforator flap for reconstruction of the extended defect after excision of the tumor. Results: The flap survived and healed without further problems. A good functional and aesthetic result was obtained. Conclusion: Ectopic primary carcinoma of breast tissue is a rare entity. Correct early diagnosis should be made. A tension-free fasciocutaneous flap according to Limberg, supercharged using a thoracodorsal artery perforator, can provide skin and soft tissue coverage for extended defects in the axilla with a satisfactory outcome. The operative procedure is easy and reliable. This is a further surgical option for soft tissue extended reconstruction in the armpit. © 2008 Springer Science+Business Media, LLC and International Society of Aesthetic Plastic Surgery.