Critical Cases
45 years old male suffering from left angle mouth carcinoma approaching to lower and upper Gingivobucxal sulcus.growth was involving outer cheek skin.mandible is not eroded.left modified neck dissection with left anterior marginal mandibulectomy with
wide excision of left angle mouth outer cheek skin with buccal mucosa done.reconstructin with bilobe left pectoralis flape done
56 years old female suffering from left breast lump since 1 month.FNAC shows carcinoma of breast.USG liver and X-ray chest are normal.left modified radical mastectomy with chest wall reconstruction with left Lattismus dorsi flape done.
42 years old male suffering from left lateral margin tongue lesion.biopsy shows wee differentiated tongue carcinoma.left modified neck dissection with wide excision of left lateral margin tongue growth with primary closure done.
52 years old female suffering from left breast lump in lower and outer quadrant.True cut biopsy shows invasive ductal carcinoma.usg of left axilla shows multiple lymph nodes.left modified radical mastectomy with left LD flape done.
75 years old male suffering from right lower GB sulcus carcinoma involving buccal mucosa.right lateral upper molar eroded ulcer also reported carcinoma.patient is having hypertension and COPD.Right modified neck dissection with right distal Mandibulectomy
with right lateral partial maxillectomy with pectoralis major myocutaneous flape done.
25 years old male suffering from left lateral margin middle third of the tongue carcinoma.size of the tumour was 2.5*1.8*1.6 cm.tumour was not invading floor mouth.ct scan shows level II necrotic node.left modified neck dissection with left tongue growth
wide excision with primary closure done.
52 years old female suffering from right breast lump since 30 days .lump was in right lower upper and outer quadrant .truce cut biopsy shows carcinoma.lump was multi centric and size of the mass was 4.4cm*1.6cm*1.3cm.sonography axilla was normal. Er PR
are positive HER 2 negative Right modified mastectomy with right LD flape was done
50 years old male suffering from left floor mouth growth with erosion of mandible.patient was operated for left lateral margin tongue carcinoma in 2020.post operative radiotherapy was given .recent CT scan shows left floor mouth growth with erosion of
mandible .left segmental mandibulectomy with floor mouth growth excision with pectoralis major flape done.
60 years old male suffering from right lower GB sulcus carcinoma involving floor mouth.CT scan shows right mandible was eroded.bilateral lymphadenopathy in neck.Right modified neck dissection with right extended hemimandibulectomy with left level 1 neck
dissection with reconstruction with bilobe PM flape was done.
51 years old male suffering from left lateral margin tongue carcinoma .growth not invading floor mouth.ct scan shows growth limited to one side of tongue .level 1 nodes are necrotic in ct scan.left modified neck dissection with wide excision of left lateral
margin tongue growth excision with primary closure done.pt is known case of hypothyroidism.
36 years old male suffering from left buccal mucosa carcinoma involving left retromolar trigone.patient is known alcoholic and his SGPT is high.patient has grade lll trismus.left modified neck dissection with left distal mandibulectomy with upper alveolectomy
with reconstruction by pectoralis major myocutaneous flape done.
55 years old female suffering from left breast lump since 2 months.skin above the tumour was involved .mammography shows 4cm * 4 cm growth with multiple axillary nodes.true cut biopsy shows infiltrating ductal carcinoma.left modified radical mastectomy
with left LD flape for chest reconstruction was done
50 years old male suffering from right buccal mucosa carcinoma since 2022.patient was operated for right commando in December 2022. Post op radiotherapy given. Now patient developed right cheek skin growth involving right parotid gland.patient was given
3 cycles of TPF but no response.then pt was given two cycles of S1 therapy.it was excellent response.90% growth was dissolved .after then today external cheek skin was covered with forehead flape.pt will be treated with 4 more
cycles of S1 therapy
65 years old male suffering from right lateral margin tongue growth invading floor mouth.biopsy shows sarcoma of floor mouth.ct scan shows growth involving floor mouth and lateral margin tongue.Right modified neck dissection with wide excision of floor
mouth and lateral margin tongue growth with primary closure done
51 Years Old Male Suffering From Right Lateral Margin Tongue Carcinoma Involving Opposite Side.Floor Mouth Was Spared.MRI Shows Level 1 Neck Nodes.Right Modified Neck Dissection With Right Extended Hemiglossectomy With Primary Closure Of Tongue Was Done.
40 years old male suffering from right buccal mucosa carcinoma involving external cheek skin.CT scan shows level 1 neck nodes.Right radical neck dissection with right segmental mandibulectomy with wide excision of right cheek growth with bilobe PM flape
done.
65 years old female operated before 3 years for left breast carcinoma.It was T1 lesion with triple negative.now patient has developed left retopectoral and inter pectoral mass involving left axillary vessels.excision of left pectoral muscle with mass
done.Left axillary vein was partially teared and sutured with 6-0 prolene.left axillary vessels was covered with advancement of local muscle.tube drain kept.
45 years old male suffering from left lower GB sulcus carcinoma involving mandible.CT scan shows multiple nodes at level 1,2.Left modified neck dissection with left lateral segmental mandibulectomy with left bilobe pM flape done.
40 years male suffering from left buccal mucosa carcinoma .growth was not involving upper and lower Gb sulcus.left modified neck dissection with wide excision of left buccal mucosa with left PM flape done.
45 years old male suffering from right buccal mucosa growth invading upper and lower gingivobuccal sulcus.Ct scan shows right level 1 ,2 neck nodes.patient has also left buccal mucosa lesion proven carcinoma.Right modified neck dissection with right distal
mandibulectomy with right lower partial maxillectomy with cheek skin and buccal mucosa growth excision with right PM flape with left buccal mucosa growth excision done.
50 years old male suffering from right lateral margin tongue carcinoma.MRI shows growth not invading floor mouth.Right modified neck dissection preserving sternocledo mastoid muscle IJV,Right spinal accessory nerve.wide excision of tongue growth with
primary closure done.
30 years male suffering from huge left buccal mucosa and mandibular growth which displace in oral cavity.HPE shows spindal cell carcinoma.pre op TC was 60,000.Bone marrow is normal.with pre op blood transfusion and higher antibiotics left hemimandibulectomy
with left cheek growth excision with left PM flape done
48 years old male suffering from left buccal mucosa carcinoma .pt was operated before one year for right lateral margin T4 tongue carcinoma .pt was radiated.pet ct shows lesion in left buccal mucosa and neck nodes.left modified neck dissection with left
wide excision of buccal mucosa with reconstruction with left PM flape done
63 years old female suffering from large ulcerative growth on forehead.biopsy shows basal cell carcinoma.wide excision with rotation of scalp flape done.
45 years old female suffering from left posterior 1/3 lateral margin tongue carcinoma invading floor mouth .There was severe trismus.CT scan shows left level 2A and 2b nodal mass.left modified neck dissection with left segmental mandibulectomy with left
posterior 1/3 lateral margin tongue excision with left PM flape done.
42 years old male suffering from right lateral margin tongue carcinoma.CT scan shows level i and ii neck nodes enlargement.Remaining investigation are normal.patient is hypertensive.Right modified neck dissection with right hemiglossectomy with primary
closure done.
47 years old nuli parous woman having lump in right breast lower and outer quadrant .True cut biopsy shows invasive ducal carcinoma .Usg and mammography shows 2.5 cm*2.5 cm growth without any axillary lymphadenopathy .right outer lower breast quadrenctomy
with axillary clearance with right LD flape for breast reconstruction done
60 years old male suffering from right neck nodal mass at level ll and lll.patient was operated for right tongue carcinoma before 8 months.patient has left radiation after ten fraction.now patient has developed neck mass involving right IJV and CCA.Right
neck nodal excision with IJV removed.open carotid vessels covered with right Pectoralis flape
60 years old male suffering from pus discharging sinus with oedema from right cheek.patient was operated in 2016 for right buccal mucosa carcinoma.at that time right distal mandibulectomy with wide excision of right buccal mucosa with right PM flape.Pet
Ct of recent time shows it is recurrent growth at cut end of mandible.Right revision mandibulectomy at cut end with wide excision of soft tissue with right tongue flape to cover inner surface of mouth cavity with advancement
of local skin flape with STG on neck raw area done
40 years old male suffering from left post 1/3 base tongue growth which involve the lt tonsillar fossa with left pharyngeal wall.patient was given one cycle of neo adjuvant chemo.after doing recent ct scan after chemo tumour was reduced 50%.left modified
neck dissection with left segmental mandibulectomy with left tossilar fossa growth excision with left PM flape done.
40 years old male suffering from left cheek growth.patient was operated before 8 months for left buccal mucosa carcinoma.left distal mandibulectomy with left PM flape was done.post op radiotherapy was given.PET CT shows growth on left cheek only.wide
excision of left cheek growth with left forehead flape was done.
60 years old female suffering from left lateral margin tongue growth.HPE shows well differentiated squamous cell carcinoma .patient was operated for right buccal mucosa carcinoma before 9 years .No RT taken by patient.Left tongue growth wide excision
with primary closure with left modified neck dissection was done.
60 years old female suffering from left breast subsreolar lesion .Excision biopsy shows ducal carcinoma.ER is positive.PET ct shows lesion in breast only.Central quadrenactomy with Reconstruction with LD flape done
60 years old male suffering from lower lip carcinoma involving both angle mouth.patient was operated for left buccal mucosa carcinoma in 2014.At that time left radical neck dissection with left distal mandibulectomy with left pM done.Today Right radical
neck dissection with wide excision of lower lip with marginal mandibulectomy with right PM and right Nasolabial flape done.
42 years old lady suffering from right breast lump in outer and upper quadrant which is 1cm *1cm.in size.usg shows no axillary nodes.Right breast upper and outer quandrentcomy with reconstruction of defect done with right LD flape.
50 years old male suffering from right lateral margin tongue growth .CT scan shows multiple lymph nodes at level II.right modified neck dissection with primary closure of tongue done.
44 years old female suffering left breast lump since 2 months.FNAC Shows left breast carcinoma.Mammography shows 3cm*3 cm mass in left breast.USG Liver and X ray CHEST NORMAL.Left modified radical mastectomy with left LD flape done.
70 years old male suffering from left buccal mucosa verrucous lesion.wide excision with nasolabial flape done
40 years old male suffering from advanced carcinoma tongue.CT scan shows left sided neck nodes.left extended hemiglossectomy with segmental mandibulectomy with left PM flape done.
39 years old male suffering from lower lip carcinoma.growth involving right angle mouth.CT scan shows bilateral neck nodes.patient was obese hypertensive and diabetic.Right modified neck dissection with left SOHND with lower lip excision with central
alveolectomy with bilateral nasolabial flape done.
70 years old male suffering from right posterior 1/3 lateral margin tongue growth .ct scan shows 2cm * 2 cm growth not invading floor mouth.no enlarged neck nodes.Right modified neck dissection with wide excision of post 1/3 tongue growth with primary
closure done.
56 years old lady suffering from left sub mental mass which was infiltrating to mandible.past h/o left marginal mandibulectomy with level 1 to 4 neck dissection before 9 months.it was T1 lesion.no RT given.now patient had left sub mental mass.PET ct shows
left mandibular canal involvement with erosion with right level 2 ,3 neck nodes.left hemimandibulectomy with right SOHND with left PM flape done.
32 years old lady suffering from left breast lump since 3 months.True cut biopsy proved carcinoma.ER ,PR,HER2 are positive.Other investigations are normal.Right modified radical mastectomy with right LD flape for reconstruction of chest wall done.
42 years old male suffering from right lateral margin tongue growth.Right modified neck dissection with primary closure of tongue defect done
55 years old male suffering from right buccal mucosa carcinoma with huge submandibular mass.mass was adherent skin .size of the mass was 8cm * 8 cm.buccal mucosa growth was involving mandible.Right modified neck dissection with distal mandibulectomy with
bilobe Pectoralis major flape done
38 years old female suffering from left breast mass since 2 year.she was operated first time for lumpectomy and reported borderline phylloid tumour.after 12 months she was operated again with recurrence and reported with recurrent phylloid tumour.not
patient has third time phylloid tumour .left simple extended mastectomy with reconstruction with left LD flape done
55 years old male suffering from recurrent lower GB sulcus carcinoma.patient was operated in 2020 for lower GB sulcus carcinoma with free fibular graft at another hospital.post operative radiotherapy given.patient has soft palate carcinoma in 2022 December
.patient was operated for that .Today left lower fibular graft removal with flape excision with reconstruction of defect with left pectoralis major myocutaneous bilobe PM flape done.
33 years old female suffering from right breast lump since 8 months .patient was operated for right breast lumpectomy before 6 months.it was ducal carcinoma .she was operated some where else.after then patient has not opted any treatment.now patient came
with two lumps in breast which was having carcinoma .Right modified radical mastectomy with right LD flape for chest wall reconstruction was done
50 years old male suffering from left buccal mucosa carcinoma with invasion of external cheek skin.CT shows level 1lymphadenopathy.patient is diabetic .left modified neck dissection with wide excision left buccal mucosa growth with external cheek skin
with reconstruction of left cheek with buccal mucosa done with bilobe PM flape.
55 years old male suffering from right tongue lateral margin growth.HPE shows moderately differentiated carcinoma.Right modified neck dissection with right hemiglossectomy done.
80 years old female suffering from right breast retroareolar lump sine 3 months.FNAC prove it is carcinoma.All remaining investigation are normal.Right modified radical mastectomy done
52 years old male suffering from right lateral margin tongue growth.Growth was extending from anterior 2/3 lateral margin tongue to lateral margin of posterior 1/3 of tongue.growth was not invading deep muscle of tongue and floor mouth.Right radical neck
dissection with wide excision of tongue growth with primary closure done.
Male patient aged 54 years was suffering from right palatial carcinoma .neo adjuvant chemo given in 2015.Right near total maxillectomy with right temporalis flape done .post op RT was given.in 2020 right soft palate growth excision done which reported
sarcomatoid carcinoma.now patient had defect in right palatial area and right lip.left cross pectoralis flape done
47 years old male having left lateral margin tongue carcinoma .patient was operated for left lateral margin tongue carcinoma excision with left RND.patient was radiated .During radiation patient developed right neck node for that right RND done.Radiation
completed before 1 year.now patient had right post auricular metastatic growth.Wide excision with scalp rotation flape was done.
42 years old lady suffering from right breast lump with axillary nodes.MR PET shows mass in right breast with axillary metastatic nodes.Right modified radical mastectomy with right lattisimus dorsi flape done.
55 years old female suffering from right buccal mucosa carcinoma since 1 year.CT scan shows Growth involving external cheek skin.Remaining all reports are normal.Right modified neck dissection with right marginal mandibulectomy with right bilobe PM flape
done.
42 years old male suffering from right buccal mucosa and right retromolar trigone growth involving lower part of maxilla.patient was given six cycles of neoadjuvant chemotherapy.Right level 2 neck node was regressed but skin was involved .Right radical
neck dissection sparing sternocledo muscle and preserving port with right distal mandibulectomy with right RMT and buccal mucosa growth excision with lower partial maxillectomy with right PM flape done.
56 years old male suffering from left lateral margin tongue posterior 1/3 carcinoma.patient was operated for right lower Gingivo buccal carcinoma in 2014.patient was radiated post operatively.patient is diabetic ,hypertensive and hypothyroid.patient has
ischemic heart disease. Left radical neck dissection with wide excision of left lateral post 1/3 tongue growth excision done with primary closure.
32 years old male suffering from right buccal mucosa growth which shows verrucus carcinoma.Pet ct shows level 1 and 3 uptake.Right modified neck dissection with right buccal mucosa growth excision with right pectoralis major myocutaneous flape done.
30 years old male suffering from left buccal mucosa carcinoma involving lower GB sulcus.Left radical neck dissection with left segmental mandibulectomy with left PM flape done
76 years old male suffering from left infra auricular cauliflower growth since 1 year.patient has chronic renal failure with diabetes.His creatine remain 3.2.Biopsy shows basal cell carcinoma.after consulting Nephrologist with all precaution wide excision
of growth done with primary split thickness skin graft.post operative recovery was normal
62 years old male suffering from left palate carcinoma .patient was operated for left lower gb sulcus carcinoma .in 2020 left commando with reconstruction with free fibular graft done.today near total maxillectomy with reconstruction with left forehead
flape done.
45 years old male suffering from advanced right buccal mucosa carcinoma involving outer cheek skin.Right radical neck dissection with right distal mandibulectomy with outer cheek skin excision with upper alveolectomy with bilobe pectoralis major myocutaneous
flape done
