Critical Cases
33 years old male suffering from left retromolar trigone growth extending in to upper GB sulcus.pt has retraction of overlying cheek skin.CT scan shows erosion of upper alveolus.
Left modified neck dissection with left distal segmental mandibulectomy with left upper alveolectomy with bilobe PM flape done.
50 years old male having upper FB sulcus carcinoma since 30 days .oatient was operated for lower GB sulcus carcinoma before 18 months at other place.At that time left segmental mandibulectomy with free fibular graft was done.post op radiotherapy was given.after that pt develope upper Gb sulcus carcinoma .Left lower partial maxillectomy with primary STG with dental prosthesis was kept.pet ct shows lesion in upper left palate only.
48 years old male having right lower gingivobucxal carcinoma before 4 years .pt was operated and post op radiotherapy given.before 15 days is having right soft palate ulcer which shows carcinoma .wide excision with right lateral tongue flape done.
49 years old male suffering from right soft palate and right poterolateral pharyngeal carcinoma.Pt was operated for right tongue carcinoma before 4 years.right lower partial maxillectomy with posterior pharyngeal growth excision with reconstruction with right temporalis muscle done.
42 years old male suffering from right lower FB sulcus growth involving alveolar margin and outer lip skin.patient was operated for left buccal mucosa growth before 3 years .It was T1 lesion .patient was kept under observation .right modified neck dissection with right marginal mandibulectomy with right Pectoralis flape was done.
49 years old male suffering from left lateral margin tongue carcinoma.left SOHND with wide excision of left tongue growth with primary closure done.
34 years old male suffering from left anterior 2/3 tongue carcinoma crossing midline.Floor mouth was not involved.Left extended hemiglossectomy with modified neck dissection with free radial forearm flape was done
47 years old female suffering from right parotid deep lobe tumour extending to parapharyngeal space encasing external carotid for 180 degree and pushing right IJV.true cut biopsy shows pleomorphic adenoma.Right deep lobe parotidectomy done.
58 years old male suffering from right buccal mucosa carcinoma since 30 days.patient was operated for right lateral margin tongue carcinoma before 18 months.patient was radiated at that time.not patient has right buccal mucosa carcinoma without any spread.Right distal marginal mandibulectomy with wide excision of right buccal mucosa growth excision with right PM flape done
37 years old female suffering from left chest wall mass since 2 months.mass is painful.patient has past h/o left breast carcinoma surgery in 2020.patient has triple negative disease.8 cycles chemo given.pet ct shows tumour on left chest wall only.wide excision of left chest wall tumour with left LD flape done
37 years old male suffering from right lateral margin tongue carcinoma.AP diameter is 5 to 6 cm and growth was free from floor mouth.Level 1 neck nodes are necrotic .right modified neck dissection with right hemiglossectomy with reconstruction of tongue with free radial forearm flape done.
38 years old female suffering from advance left breast carcinoma.Lumpectomy was done before 2months reported carcinoma breast.ER -PR negative.Her 2 positive.multiple axillary nodes.Left modified radical mastectomy with upper abdominal rotation flape was done.
47 years old male suffering from left buccal mucosa growth involving left lower gingivo buccal sulcus with outer cheek skin.upper gingivobuccal sulcus is 6mm away from growth.left modified neck dissection with left distal mandibulectomy with left cheek skin and buccal mucosa growth excised with bilobe pectoralis flape done.
67 years old male suffering from post radiation osteonecrosis of mandible .past history of lt tongue carcinoma befor 2 years .for that left commando followed by radiation was done.past history of right lower Gb sulcus carcinoma before 7 years.for that free fibular graft done.today left hemimandibulectomy with left PM flape done.
52 years old male suffering from left tongue carcinoma invading floor mouth.left modified neck dissection with with extended left hemiglossectomy with left pectoralis major flape done.
62 years old male suffering from subglottic carcinoma .patient was radiated for base tongue carcinoma in jan 24 with radiotherapy .pet ct shows new lesion in subtopic region.patient had severe subglottic tracheal stenosis.patient was operated for Laryngectomy with pharyngectomy with patch pharyngoplasty with pectoralis muscle.
51 years old male suffering from left buccal mucosa carcinoma not involving retro molar trigone.Ct scan shows 2cm x 1.8cm x.8cm growth without any significant lymphadenopathy .Left modified neck dissection with wide excision of left buccal mucosa growth primary closure with buccal pad of fat.
40 years old male suffering from right parotid swelling.MRI shows tumour was arising from right deep lobe of parotid pushing the fascia nerve medially with extension of tumour in neck.the size of the tumour was 8cm x 7cm.
Right total parotidectomy with complete preservation of fascia nerve was done.
60 years old male suffering from left palatal carcinoma reaching to supra notch level and eroding floor of maxilla.three cycles neo adjuvant chemo given.post chemo pet ct shows complete resolution of tumour.left upper distal mandibulectomy with left lower partial maxillectomy with ALT done.
67 years old female suffering from non healing ulcer on nose since 3 months.patient is not responding to any local medicines.biopsy of ulcer proved it to basal cell carcinoma.wide excision with mid line forehead flape was done.
30 years old male suffering from right lower gingivobucxal carcinoma having extensive metastatic lymphadenopathy .Patient was given three cycles of Neo adjuvant chemotherapy .CT scan shows complete thrombosis of right IJV with extension to brachiocephalic vein .Right modified neck dissection with right distal mandibulectomy with right PM flape done.
27 years old female having swelling in right submandibular area haveing stone in duct.Right submandibular gland excision done.
47 years old female suffering from left breast lump in upper and outer quadrant involving outer skin.Sonography shows level 1 axillary nodes.USg liver is normal.left modified radical mastectomy with left LD flape done.
42 years old male suffering from advance left buccal mucosa carcinoma.The growth was involving left mandible ,maxilla and floor mouth.left hemimandibulectomy with left lower partial maxillectomy with wide excision of left buccal mucosa growth with bilobe PM flape done.
57 years old female suffering from left breast lump since 2 months.FNAC shows it is ductal carcinoma.left axillary sonography was normal.patient is diabetic and having hypothyroidism.Left skin sparing mastectomy with reconstruction by Lattismus dorsi flape done.
51 years old female suffering from left breast lump since 2 1/2 months.Left breast lumpectomy was done outside shows mucinious carcinoma with ductal carcinoma of breast .usg shows some enlarge nodes in axilla.left skin sparing mastectomy with left axillary clearance with left latissimus dorsi flape for chest wall reconstruction done
71 yrs old female suffering from left breast mass in upper and inner quadrant of breast.USG axillary shows some enlarge nodes.true cut biopsy proves it carcinoma .Left modified radical mastectomy with primary closure done.
51 yrs old male suffering from right buccal mucosa carcinoma involving angle mouth.There were multiple neck nodes at level l and ll.Right modified neck dissection with wide excision of right angle mouth with buccal mucosa with reconstruction of defect
with nasolabial and local flape was done.
71 years old male suffering from right lateral margin tongue growth .Anetrio posterior diameter was 5 cm.The growth was not reaching to floor mouth and not crossing the midline.Right modified neck dissection with wide excision of right lateral margin
tongue growth with primary closure done
49 years old female suffering from left breast carcinoma having size of 3.2 cm x2.8cm x2.2cm .the tumour was in upper inner and outer quadrant nearer to nipple.Skin sparing left modified mastectomy with left Lattisimus dorsi flape was done
36 years old male suffering from left neck nodal mass having size of 7cm x 7cm infiltrating to left IJV and CCA. Pet CT shows mass in left neck node without any primary.left modified neck dissection with left PM flape to cover the carotid vessels.
36 years old female suffering from right upper GB sulcus carcinoma .CT scan shows bilateral neck lymphadenopathy .Othe investigation are normal .Right modified neck dissection with left SOHND with right upper lower partial maxillectomy with right nasolabial
flape done
36 years old female suffering from right upper GB sulcus carcinoma .CT scan shows bilateral neck lymphadenopathy .Othe investigation are normal .Right modified neck dissection with left SOHND with right upper lower partial maxillectomy with right nasolabial
flape done
63 years old female suffering from left buccal mucosa carcinoma involving upper and lower gingivo buccal sulcus.The tumour was extending to left retromolar trigone.Left modified neck dissection with left distal mandibulectomy with left upper alveolectomy
with left PM flape done.
63 years old female suffering from left buccal mucosa carcinoma involving upper and lower gingivo buccal sulcus.The tumour was extending to left retromolar trigone.Left modified neck dissection with left distal mandibulectomy with left upper alveolectomy
with left PM flape done.
60 years old female suffering from Right breast upper and outer quadrant mass.There were multiple nodes in Axilla.Right modified mastectomy with primary closure done.
42 years old male suffering from right buccal mucosa carcinoma invading right cheek skin with large submandibular nodal mass.patient is on anti tuberculous treatment since 90 days.patient is having extensive bilateral pulmonary loci’s.Right modified neck
dissection with right hemimandibulectomy with wide excision of right cheek growth with bilobe PM flape done
42 years old female suffering from left buccal mucosa carcinoma involving lower GB sulcus with erosion of mandible.pt has also left lateral margin tongue lesion looks like verrucus lesion.Left modified neck dissection with left distal segmental mandibulectomy
with wide excision of left buccal mucosa growth with wide excision of left lateral margin tongue lesion with Reconstruction with PM flape done.
60 years old male suffering from Right buccal mucosa carcinoma involving outer cheek skin with large sub mandibular cystic necrotic mass.pt is diabetic and hypertensive.ct scan shows involvement of mandible and upper alveolus.Right modified neck dissection
with right hemimandibulectomy with wide excision of right cheek growth with bilobe pectoralis flape done.
36 years old male suffering from right floor mouth and lateral margin tongue carcinoma.CT scan shows multiple neck nodes .Right modified neck dissection with right lateral margin tongue with right floor mouth growth excision with primary closure done
47 years old male suffering from lower central arch gingivitis buccal carcinoma.MRI shows growth involving the outer cortex of mandible.CT scan shows bilateral neck nodes.Right modified neck dissection with left SOHND with central arch marginal mandibulectomy
with bilateral nasolabial flape done.
47 years old female suffering from Right upper GB sulcus and alveolus carcinoma eroding the alveolar arch.CT scan shows level I II nodal enlargement.Right modified neck dissection with Right upper alveolectomy with right upper GB mucosal excision with
right palatal flape with right nasolabial flape done
42 years old male suffering from left upper alveolus and left upper GB sulcus carcinoma.HPE shows sarcomatoid carcinoma .MRI shows growth involving inferior maxillary wall and medial pterygoid muscle .left modified neck dissection with left near total
maxillectomy with left PM flape done.
67 years old female suffering from left breast advance growth.HPE shows Invasive ductal carcinoma .left Axilla shows multiple metastatic nodes adherent to left axillary vein.Left modified radical mastectomy with primary closure done.
70 years old male suffering from left post 1/3 tongue carcinoma invading muscle of floor mouth.patient has left level 2 & 3 positive neck nodes.left modified neck dissection with left distal segmental mandibulectomy with wide excision of posterior 1/3
tongue growth with floor mouth growth excision with left Pectoralis major flape done.
42 years old male suffering from left upper alveolus and GB sulcus carcinoma.HPE shows sarcomatoid carcinoma.MRI shows growth involving inferior maxillary wall and medial pterygoid muscle.Left modified neck dissection
70 years old female suffering from left medial parth of thigh skin cutaneous malignancy with prepuertal cutaneous nodules.patient was operated for left extended vulvectomy with left inguinal node clearance.it was reported T3N1M0. Radiation was planned
but unfortunately before start of radiation patient has recurrence at local site.so wide excision of all cutaneous malignant nodules with coverage of raw area with advancement of flape with STG done.
77 years old male suffering from left maxillary tumour.The tumour was eroding ant and post wall of maxilla.Patient was operated for left lower GB sulcus carcinoma in 2021.Today left total maxillectomy with forehead flape done
61 years old male suffering from right lateral ant 2/3 tongue carcinoma involving floor mouth.patient was operated in 2019 for right buccal mucosa carcinoma with ALT flape.post op RT was given.in 2021 left buccal mucosa carcinoma T1 lesion wide excision
was done .Left SOHND done.This time right segmental mandibulectomy with right extended hemiglossectomy with right PM flape done.
46 years old female suffering from left upper outer quadrant breast lump.lumpectomy was done outside.it is reported invasive ductal carcinoma .other investigations are normal.considering tumour size left upper outer extended quandrectomy with axillary
clearance with LD flape done.
80 years old female suffering from left breast mass in upper and inner quadrant with blood discharging sinus.mass was 6 cm * 6cm involving skin.Usg shows no lymphadenopathy .x ray chest is normal.left modified mastectomy with primary closure done.
55 years old male suffering from right buccal mucosa carcinoma extending in right retro molar trigone.Right modified neck dissection with right distal mandibulectomy with right upper alveolectomy with right pectoralis major flape done.
46 years old female suffering from right lower gingivobuccal carcinoma without invasion of mandible.ct scan shows lesion is 1.5cm* 2.0cm. No neck lymphadenopathy .Right modified neck dissection (preserving sternocledo mastoid and spinal accessory nerve)
with right marginal mandibulectomy with right nasolabial flape done.
40 years old female suffering from advance right buccal mucosa carcinoma invading outer cheek skin.Right mandible was eroded.right radical neck dissection with right hemimandibulectomy with right lower partial maxillectomy with right cheek growth excision
with bilobe PM flape done.
70 years old female suffering from multi centric right breast tumour.true cut biopsy shows is is ductal carcinoma .patient is diabetic and hypertensive.Right modified radical mastectomy with rotation flape to cover the chest wall done.
46 years old female suffering from left breast lump since 15 months.left breast lumpectomy was done before 1year.HPE shows left breast phylloid tumour.after then patient had again tumour in left breast at same site.FNAC shows phylloid tumour.left breast
extended lumpectomy done.HPE shows malignant phylloid.Again left breast modified mastectomy with left KD flape was done
49 years old male suffering from right lateral margin tongue growth .Growth is not crossing midline.Ct scan shows growth on lateral margin without invasion of floor mouth.right modified neck dissection with right lateral margin tongue growth excision
with primary closure done
68 years old male suffering from left neck metastatic nodal mass involving left internal jugular vein and left Internal carotid artery.Primary was in left pyriform fossa.pet ct shows metastatic nodal mass in neck with primary in left PF.left modified
neck dissection with left IJV excision with left PM flape done.
55 years old male suffering from left lateral margin tongue growth .growth was touching to midline and involving the floor mouth and left GB sulcus.There was big submandibular nodal mass which was involving the diagastric and mylohoid muscle.left modified
neck dissection with left segmental mandibulectomy with left extended hemiglossectomy with submandibular mass excision done.Defect was closed with pectoralis major flape.
50 years old male suffering from right lower GB sulcus carcinoma involving central arch.patient was operated for left lower GB sulcus carcinoma before 1year.at that time segmental mandibulectomy with free fibular graft was made.right lower FB sulcus growth
was involving fibular graft also.right extended hemimandibulectomy with central arch of mandible excision with fibular graft removal with closure of defect was done with bilobe PM flape done
50 years old female suffering from right breast lump since 2 months.Lump was in outer and upper quadrant of breast.right modified radical mastectomy with breast reconstruction with right LD flape done.
83 years old female suffering from left breast lump since 3 months.lump was suddenly increase in size.FNAC shows breast carcinoma .usg of liver and axilla were normal .left modified radical mastectomy was done.
53 years old male suffering from right buccal mucosa advanced carcinoma .Growth was involving outer cheek skin.right mandible was eroded.Right modified neck dissection with wide excision of right cheek growth with buccal mucosa with right hemimandibulectomy
with bilobe pectoralis major flape done.
58 years old male suffering from left pyriform fossa growth extending in to posterior pharyngeal wall.patient had two attacks of CV stroke.patient is known case of diabetes and hypertension .Laryngectomy with pharyngectomy with posterior pharyngeal growth
excision with patch pharyngoplasty with left pectoralis flape done
57 years old male suffering from right neck node mass which was very badly adherent with right common carotid artery.Right IJV was completely involved.right extensive nodal clearance with right RND done.Right IJV was removed.vessels were covered with
right pectoralis muscle.
39 years old female suffering from right breast upper and outer quadrant mass.USG axilla shows single necrotic node.Rest of the investigations are normal.Right upper and outer quadranctetomy with axillary clearance with right LD flape done
39 years old male suffering from right buccal mucosa carcinoma locally advanced and involving outer cheek .ct scan shows erosion of mandible .level 1 neck node is necrotic.patient has complete trismus.right modified neck dissection with right hemimandibulectomy
with right lower partial maxillectomy with wide excision of right cheek growth with bilobe PM flape was done.
56 years old female suffering from left vulval carcinoma extending to peri urethral area.left inguinal nodes are necrotic.left inguinal node Clearance with left extended vulvectomy with rotation local flape done.