Myocutaneous flaps have become increasingly popular in reconstructive head and neck surgery. As surgeons have gained familiarity with them, many of the advantages, limitations, and complications of these flaps have become apparent. A rare but serious complication of myocutaneous flaps is recurrent tumor within the pedicle. Three cases of squamous cell carcinoma involving three different myocutaneous flaps are presented and the literature is reviewed. Possible mechanisms of tumor metastasis to myocutaneous flap pedicles are discussed. Surgeons must be aware of the possibility of tumor involvement of reconstructive flaps to facilitate early diagnosis and aggressive treatment.
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