Donor Site Tumor Recurrence Following Pectoralis Major Myocutaneous Flap Reconstruction in Advanced Tongue Squamous Cell Carcinoma: Interesting Image of a Rare Complication.

We present a case of a 43-year-old woman with advanced squamous cell carcinoma (SCC) of the tongue who underwent subtotal glossectomy, neck dissection, and pectoralis major myocutaneous flap reconstruction (which is widely used in head and neck reconstruction). Follow-up 18 F-FDG PET/CT scans revealed recurrence not only at the primary site but also at the donor site of the flap, and histopathology confirmed metastatic SCC at the chest wall. This case highlights the potential for rare but serious complications following flap-based reconstruction and underscores the importance of careful imaging interpretation during follow-up.