Critical Cases
75 years old female suffering from left breast mass since 3months.mass was involving outer
breast skin.multiple lymph nodes were in axilla.patient has left pleural effusion and it
shows non malignant.right modified mastectomy with primary closure done.
36 years old male suffering from lower Gb sulcus carcinoma.CT scan shows involvement of
lower alveolus with left neck nodes.left modified neck dissection with central arch marginal
mandibulectomy with lower Gb sulcus growth excision with bilateral nasolabial flape done.
65 years old male suffering from lower Gb sulcus carcinoma involving lower mandible central
arch.patient was operated for right buccal mucosa carcinoma before 3 years.left modified
neck dissection with left lower marginal mandibulectomy with pectoralis flap done.
70 years old female suffering from left breast outer and lower quadrant mass infiltrating to
skin
Left modified radical mastectomy with primary closure done.
70 years old male suffering from left lateral margin tongue carcinoma.patient having
diabetes ,hypertension with human immuno deficiency virus since 10 years.After assessing
left modified neck dissection with wide excision of left lateral margin tongue growth with
primary closure done.
40 years old male suffering from right buccal mucosa carcinoma involving lower GB sulcus.CT
scan shows growth involving lower GB sulcus.Right modified neck dissection with right
segmental mandibulectomy with right PM flape done.
37 years old male suffering from right buccal mucosa carcinoma involving upper and lower GB
sulcus and having big submandibular mass with involvement of right external cheek skin.Right
modified neck dissection with right hemimandibulectomy with upper alveolectomy with excision
of external cheek skin with bilobe PM flape done.
57 years old male suffering from carcinoma left pyriform fossa carcinoma involving lateral
pharyngeal wall.patient is diabetic and hypertensive.Laryngectomy with pharyngectomy with
left PM flape for patch pharyngoplasty was done.
55 years old male suffering from left tongue carcinoma since 2 months.patient was operated
for left lower Gb sulcus verrucous carcinoma in 2012 and operated for left buccal mucosa
carcinoma in 2022 with free radial forearm flape with post op RT plus CT.Today left Ant 2/3
and post 1/3 lateral margin tongue growth excision with pectoralis flape done.
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.
