Lymph node metastases in a pedicled pericardial fat pad flap.

Routine use of pedicled thymus or pericardial fat pad flap for prophylactic bronchial stump coverage in neoadjuvant treated non-small cell lung cancer (NSCLC) is challenged by the observation of synchronous lymph node metastases to the flap. As a consequence, we suggest local muscle flaps, and histological examination of the pericardial fat pad.