Rectus abdominis muscle transplant for repair of abdominal wall defects required for cancer resections: Case report

BACKGROUND: Cancer cells from peritoneal metastases may gain access to tissues of the abdominal wall. If laparotomy or laparoscopy is performed in a patient with peritoneal metastases, the abdominal incision or trochar sites may become seeded by cancer cells. Progression of disease may require resection if cancer at other sites can be controlled. METHODS: Metastases in an appendectomy incision occurred from peritoneal metastases of an appendiceal mucinous adenocarcinoma. The clinical features and treatment strategy of this condition in a single patient was studied. RESULTS: In this patient, cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) was used to eradicate the peritoneal metastases. The cancer isolated within the appendectomy site was resected leaving a large abdominal wall defect. The defect was closed by a rectus abdominis muscle flap dissected from the contralateral side of the abdominal wall. No mesh was required. CONCLUSIONS: Abdominal wall defects from resection of cancerous masses of the abdominal wall can be closed with a contralateral rectus abdominis muscle transplant in the absence of mesh.