Cysticercosis Infested Pectoralis Major Myocutaneous Flap Reconstruction: An Ethical Dilemma.

Disseminated cysticercosis is a rare manifestation of cysticercosis, a relatively common tropical disease in Asia, Africa and South America. Here the embryo of pork tapeworm Taenia Solium gets disseminated to multiple organs and tissues via hepatoportal system. we report here a 45 year gentleman with stage IV oral malignancy who was incidentally found to have disseminated cysticercosis on pre-operative work up. Along with the management of primary cancer and new found asymptomatic disseminated cysticercosis, the ethical challenge was to choose an appropriate reconstructive option for the composite oral cavity resection defect, since all the skeletal muscles in body where studded with cysticercosis larvae. We couldn't find any such report in literature to resolve our dilemma. After surgical board discussion, we zeroed down to pedicled pectoralis major myocutaneous flap, the most versatile and workhorse flap for head and neck reconstruction. Eventually the patient underwent surgery and adjuvant radiotherapy without any delay. He was simultaneously treated with oral albendazole under steroid cover and remained complication free at 2 years.