Critical Cases
57 years old female suffering from left buccal mucosa growth involving left RNT and gingival surface of lip extending up to right angle mouth.left modified neck dissection with left distal segmental mandibulectomy with wide excision of left buccal mucosa with left RMT growth with excision gingival margin of lower lip with left pectoralis with right nasolabial flape done.
52 years old female suffering from left breast tumour involving upper and outer quadrant.USG no axillary nodes.HRCT chest normal.USG liver normal.left modified mastectomy done.
67 years old female suffering from left buccal mucosa lesion which involves left cut end of mandible.Patient was operated for left buccal mucosa carcinoma before 2 years.post op radiotherapy was given.patient developed left parotid ,right trapezius,lungs and liver metastatic lesion.PDL1 was strongly positive.9 cycles of KEYTURDA shows 200% metabolic response at all sites except left buccal mucosa lesion.wide excision of left buccal mucosa lesion with distal end mandible removal with cross pectoralis flape done.
67 years old female suffering from left thyroid swelling reaching up tovretrosternal area .swelling was adherent to sternocledomastoid and abutting the IJV.left hemithyroidectomy done.
67 years old male suffering from left neck nodes at level 2,3,4.mass wad invading left IJV.patient was operated for right tongue carcinoma befor 1 year.It was T1N0M0,left radical dissection removing IJV with mass and primary closure was done.
52 years old female suffering from left buccal mucosa carcinoma with level 1 metastatic nodes.all remaining investigation are normal.left modified neck dissection with left segmental mandibulectomy with wide excision of buccal mucosa growth with left pectoralis flape done.
57 years old female suffering from left ant 2/3 lateral margin tongue carcinoma.CT scan shows no significant lymphadenopathy .left modified neck dissection with left ant 2/3 tongue growth excision with primary closure done.
96 years old male suffering from left maxillary mass involving anterior and inferior wall of maxilla.CT scan shows no neck nodes.left near total maxillectomy with left temporalis flape done.
35 years old female suffering from left breast recurrent carcinoma.patient was operated before 3 years for left modified mastectomy with reconstruction of left chest wall with left LD flape.now patient has recurrent mass in flape area.pet ct shows local recurrence only.wide excision of flape with malignant nodules with reconstruction of left chest wall with local flape.
40 years old male suffering from right retromolar trigone growth .patient has trismus due to lesion.griwth was not invading any bone.Right radical neck dissection with right distal mandibulectomy with upper alveolectomy with reconstruction with pectoralis flape was done.
35 years old male suffering from left buccal mucosa carcinoma involving upper and lower gingivobuccal sulcus with extension in outer cheek skin.Left radical neck dissection with left distal mandibulectomy with upper lower partial maxillectomy with wide excision of buccal mucosa with outer cheek skin with reconstruction with bilobe pectoralis flape done.
48 years old male suffering from left buccal mucosa carcinoma having size of 2..6cm*1.8cm.CT scan shows no significant lymphadenopathy .Left modified neck dissection with wide excision of left buccal mucosa growth with left nasolabial flape done.
51 years old female suffering from right breast lump since two months.size of lump was 4cm*4cm.MRI breast shows lesion having BIRADS category III lesion.true cut biopsy shows
Spindal neoplasm ,Phylloid tumour.Right breast central quadrenctetomy with filling defect closure with local rotation flape was done.
51 years old male suffering from right post 1/3 tongue lesion having so ze of 1.8*1.5cm.CT scan shows no lymphadenopathy .Right modified neck dissection with wide excision of right post 1/3 tongue growth with primary closure done.
45 years old male suffering from right post 1/3 lateral margin tongue growth with multiple metastatic neck nodes at level 1 to 5.
Right IJV was involved.Right radical neck dissection removing right IJV,spinal accessory and stereno cledo mastoid with wide excision of right tongue growth with primary closure done.
45 years old male suffering from right buccal mucosa carcinoma not involving upper and lower GB sulcus.Right modified neck dissection with wide excision of right buccal mucosa growth with reconstruction with right nasolabial flape done.
45 years old male suffering from left buccal mucosa carcinoma involving left retromolar area and approaching to upper and lower GB sulcus.patient has 25% LVEF.after testing cardiovascular condition patient was taken for surgery.Left modified neck dissection with left distal mandibulectomy with wide excision of left buccal mucosa growth with upper alveolectomy with pectoralis flape was done.
52 years old male suffering from left tongue ulcer which is proven to be wee differentiated tongue carcinoma.MRI shows lesion is T1.left modified neck dissection with wide excision of left tongue growth with primary closure done.
58 years old female suffering from left thigh non healing ulcerated growth since 3 months.Biopsy proven to be basal cell carcinoma .considering possibility of squamous component wide excision with more margin and depth was done.Raw area was covered with primary skin graft.
42 years old male suffering left ant 2/3 tongue carcinoma not invading floor mouth and bone.MRI shows growth crossing ant mid line but not reaching up to post 1/3 part of tongue.left modified neck dissection with extended ant 2/3 glossectomy with reconstruction by nasolabial flape done.
45 years old male having left lower gingivo buccal growth involving lateral mandible with extension of mass up to central arch without mandibular erosion.left modified neck dissection with left lateral segmental and central arch marginal mandibulectomy with reconstruction of defect with left pectoralis flape was done.
42 years old male suffering from right lateral margin tongue carcinoma.Tumour was reaching up to midline but not crossing it.floor mouth was not involved and lower GB sulcus was spared .Right modified neck dissection with right hemiglossectomy with right nasolabial flape was done.
39 years old male suffering from left buccal mucosa carcinoma reaching up to lower GB sulcus.Ct scan shows multiple neck nodes at level 1,2.left modified neck dissection with left segmental mandibulectomy with wide excision of left buccal mucosa with left PM flape done.
42 years old male suffering from right buccal mucosa carcinoma involving right cheek skin with angle mouth.Growth was reaching up to inferior GB sulcus but not involving.superior GB sulcus was normal.Right modified neck dissection with wide excision of right buccal mucosa growth with external cheek skin with bilobe PM flape done.
31 years old female having left breast upper and inner quadrant mass.True cut biopsy shows invasive ductal carcinoma.patient has triple negative disease.Pet ct shows left axillary nodes positive.considering age of patient neo adjuvant chemo was planned.with one cycle patient has 90% response.patientcwas explained to go for breast conservation surgery but patient was not ready and wants to get conventional modified mastectomy.so skin sparing mastectomy with left LD flape done.
40 years old male suffering from right lateral margin posterior 1/3 tongue growth not involving floor mouth.CT scan shows sub centimeter neck nodes.right modified neck dissection with right lateral margin tongue growth wide excision with primary closure done.
70 years old female suffering from right thyroid swelling .CT neck shows right thyroid swelling looking benign in nature .thyroid function are normal.there is cystic swelling in midline of neck.right hemithyroidectomy with excision of thyroglossal cyst done.
71 year old lady suffering from bilateral breast mass.True cut biopsy shows invasive ductal carcinoma.HRCT chest normal.USG liver and pelvis is normal.bilateral modified mastectomy with primary closure done.
42 years old female suffering from right lateral and ventral surface of tongue growth .CT scan shows subcentimeter nodes at level 1 and2.Right modified neck dissection preserving sternocledo madtoid and spinal accessory Nerve done.Wide excision of right tongue growth with primary closure done.
42 years old male suffering from left mandibular pain .CT scan shows pathological fracture in left distal segment of mandible.patient was operated For left tongue carcinoma twice in 2019 & 23 Left distal segmental mandibulectomy with wide excision of floor mouth growth with left PM flape done.
52 years old male suffering from right buccal mucosa advance carcinoma.Growth was involving right cheek dermal layer.There was big metastatic nodal mass at level 1 and level 2 B.Right radical neck dissection sacrificing spinal accessory nerve and right hypoglossal nerve.Right distal mandibulectomy with wide excision of right cheek growth with outer cheek skin with reconstruction with bilobe PM flape was done.
68 years old male suffering from right maxillary tumour having sinus on palatal side.CT scan shows growth involving anterior wall and post wall of maxilla with involvement of right nasal cavity.Right modified neck dissection with right subtotal maxillectomy with right temporalis flape done.
65 years old male suffering from osteo radionecrosis of lower mandible and fibular graft.patient was operated before 5 years at Pune for right buccal mucosa carcinoma and free fibular graft was done.1 1/2 years before patient had left tongue carcinoma.left hemiglossectomy with left radical neck dissection with left pectoralis flape was done.Today wide excision of floor mouth with removal of central arch of fibular bone with left nasolabial flape was done .
70 years old female suffering from right vulval verrucus carcinoma .patient was operated before 2 years for left and Center of vulval growth .Bilateral inguinal nodes clearance with left extended vulvectomy done before 2 years .now right vulval growth wide excision with advancement of local flape was done.
47 years old female suffering from right chin growth involving right cut end of mandible.patient was operated for right retro molar trigone growth before 4 years .Right modified neck dissection with right distal mandibulectomy with reconstruction of defect with right PM flape was done before 4 years.Today wide excision of right chin growth with mandibulectomy of distal end of right side of mandible with reconstruction of defect with cross pectoralis major flape done.
45 years old male suffering from right lateral margin middle 2/3 tongue carcinoma .patient was operated for right buccal mucosa carcinoma with right hemimandibulectomy with reconstruction of defect with bilobe PM flape.wide excision of right lateral margin tongue growth excision with refashioning of lower lip with advancement of pm flape done,Tongue was primarily closed.
57 years old male suffering from pus discharging sinus since 6 moths.patient was previously operated for left buccal mucosa carcinoma.post op radiation was given.OPG show it is osteoradionecrosis.areexploration of wound with re cut of cut distal end of mandible with primary closure done.
55 years old male suffering from right lateral middle 2.3 tongue carcinoma.Growth was not crossing midline .Growth is reaching up to floor mouth but not invading.Right modified neck dissection with right middle 2/3 tongue extended glossectomy with primary closure done.
37 years old male suffering from left buccal mucosa carcinoma involving outer cheek skin.Biopsy done thrice turn out to be negative.left modified neck dissection with wide excision of cheek growth with segmental mandibulectomy with bilobe pectoralis flape done.
48 years old male suffering from right neck mass involving neck skin and level 2,3 nodes with sinus at thyroid cartilage level.mass was completely involving jugular vein and common carotid vessel was 180 degree involved.right neck dissection involving removal of right IJV,right sternomastoid and spinal accessory nerve.neck defect was covered with right pectoralis flape.
70 years old male suffering from right tongue anterior 2/3 tongue carcinoma extending submucosally to midline but not crossing .Right modified neck dissection with right extended hemiglossectomy with reconstruction of tongue with right pectoralis flape done.
65 years old male suffering from left ant 2/3 lateral margin tongue carcinoma.patient was operated for left buccal mucosa carcinoma with left distal mandibulectomy in 2021.patient was radiated in 2021.now patient has second malignancy.wide excision of left lateral ant 2/3 tongue growth excision with left nasolabial flape done.
27 years old female suffering from early breast carcinoma.lump was in inner and lower quadrant.usg and mammogram shows residual mass in breast .right breast lumpectomy done outside.HOE shows ductal carcinoma.right modified mastectomy done.
47 years old male suffering from right breast recurrent carcinoma.patient was operated for right breast lumpectomy proven to be carcinoma.No post operative treatment was offered to patient.now patient has very big axillary mass with right breast mass and right supraclavicular node.right radical mastectomy with right axillary clearance with rotations abdominal flape with primary STG at donor site done.
60 years old male suffering from ant 2/3 tongue carcinoma involving floor mouth and crossing midline of tongue.MRI shows whole ant 2/4 of tongue was involved and growth involving muscles of tongue and floor mouth.Right modified neck dissecvwith right extends ant2/3 tongue excision with right lateral segmental mandibulectomy with reconstruction of tongue and floor mouth done with right pectoralis muscle.
48 years old female suffering from right buccal mucosa carcinoma extending in to right retromolar trigone.ct scan shows mandibular erosion .Right modified neck dissection with right distal mandibulectomy with wide excision of right buccal mucosa and right retromolar growth with reconstruction with right pectoralis flape was done.
46 years old male suffering from left lateral margin tongue carcinoma.growth is not invading floor mouth.wide excision of left lateral margin tongue growth with modified neck dissection with primary closure done.
67 years old male suffering from left palatal carcinoma reaching up to base skull.patient was operated before 1 year for left mandibulectomy with lower partial maxillectomy .patient was post op was radiated.now patient has recurrent palatal growth .neo adjuvant chemo 6 cycles were given .patient has 80% response.today left subtotal maxillectomy with left forehead flape was done.
46 years old female operated for Laryngectomy with pharyngectomy and reconstruction of pharynx with patch pharyngoplasty done.post radiation patient has upper pharyngeal stricture.revision of pharyngoplasty with excision of all scar of pharynx with patch pharyngoplasty done.
62 years male suffering from right todillar carcinoma since 1 year.recent CT shows growth involving right lateral and posterior pharyngeal wall.patint has multiple right neck nodes abutting IJV.one big mass involving right angle mandible neck skin.Tight modified neck dissection with right pectoralis flape done
42 years old female having left breast lump upper and outer quadrant.True cut biopsy shows invasive ductal carcinoma.usg axilla shows no significant lymphadenopathy .mammography shows 2.5*2cm mass in breast.left upper and outer quadrenctectomy with reconstruction with left LD flape done.
62 years old male suffering from right floor mouth with tongue carcinoma .patient was operated for lower gingivobuccal growth in 2019 and for that patient was operated bilateral SOHND and central arch mandibulectomy .with newer growth wide excision of right floor mouth growth with right lateral margin tongue excision with left pectoralis flape for reconstruction done.
42 years old male suffering from right lateral margin tongue growth having size of 1.5cm*2.0 cm.CT scan shows level 2 lymph nodes.Right modified neck dissection with wide excision of right lateral margin tongue growth with primary closure done.
48 years old female suffering from from left breast carcinoma.size of tumour was 3.5 *3 cm.ct axilla shows axillary node.patient is 98kg weight having hypothyroid ,diabetes and hypertensive.left breast skin sparing mastectomy
With primary closure done.
48 years old male suffering from left lateral margin tongue carcinoma.size of lesion is 2 cm X 1.8 cm.ct scan shows no neck nodes.wide excision of left lateral margin tongue growth with left modified neck disssection with primary closure of to due defect done
45 years old male suffering from left lower GB sulcus carcinoma involving cut end of mandible with previously posted flape.Growth is involving outer cheek skin.wide excision of lower Gb growth with excision of cut end of mandible with partial excision of flape with bilobe PM flape was done.
61 years old male suffering from right lower lip carcinoma involving angle mouth.Pt was operated for left buccal mucosa carcinoma before 3 years .No RT was given at that time.ct scan shows right lower lip growth with level 1 neck nodes.Right modified neck dissection with
Wide excision of right lower lip wth right nasolabial flape done.
65 years old male suffering from lower Gb sulcus central arch carcinoma involving outer chin skin.bilateral neck nodes are positive.Bilateral SOHND with central arch mandible marginal mandibulectomy wilt wide excision of lower Gb sulcus growth with reconstruction with bilateral nasolabial flape done
48 years old male suffering from left advance buccal mucosa carcinoma involving outer cheek skin.left mandible and maxilla were involved .left modified neck dissection with left hemi mandibulectomy with wide excision of outer cheek with buccal mucosa growth with lower partial maxillectomy with left bilobe pm flape done.
48 years old female suffering from right buccal mucosa carcinoma involving outer cheek skin.lower GB sulcus was involved.Right modified neck dissection with right distal segmental mandibulectomy with wide excision of right buccal mucosa growth with bilobe pectoralis flape done.
46 years old male suffering from large right side neck fungating mass with right lower GB sulcus carcinoma .ct scan shows mass involving right parotid gland.wide excision of right neck nodal mass with level 1,2,3,4 neck clearance with distal mandibulectomy with bilobe pectoralis flape done.
46 years old male suffering from large right side neck fungating mass with right lower GB sulcus carcinoma .ct scan shows mass involving right parotid gland.wide excision of right neck nodal mass with level 1,2,3,4 neck clearance with distal mandibulectomy with bilobe pectoralis flape done.
39 years old male suffering from right lower Gingivo buccal carcinoma not involving mandible.CT shows level 2,3 neck nodes.Right modified neck dissection with right distal marginal mandibulectomy with pectoralis major flape done.
38 years old male suffering from right anterior 2/3 tongue carcinoma with exophytic right sub mental nodal mass with multiple right neck nodes involving right IJV and carotid fat planes.Right modified neck dissection with right sunmental nodal excision with right lateral segmental mandibulectomy with with wide excision of right ant 2/3 tongue with bilobe pectoralis flape done.
43 years old female suffering from left buccal mucosa carcinoma.CT scan shows no neck lymphadenopathy.Remaining investigation are normal.Left modified neck dissection with left buccal mucosa growth excision with left distal segmental mandibulectomy with left upper alveolectomy with left Pectoralis major flape done.
68 yrs old male suffering from base tongue carcinoma of left side.patient was radiated before 4 months with weekly cis platin.it was partially responded .Pet ct shows tumour confined to left base tongue reaching up to epiglottis .left modified neck dissection with wide excision of left base tongue growth with reconstruction with left PM flape done.
37 years old male suffering from post cricoid carcinoma.growth involving ant and lateral pharyngeal wall.patient has difficulty in deglutition.Laryngectomy with pharyngectomy with pectoralis patch pharyngoplasty done
37 years old male suffering from lower lower Gb sulcus carcinoma involving chin skin and inner lingual surface of Gb sulcus.CT shows outer chin skin involvement .left modified neck dissection with left latero central arch mandibulectomy with PM flape done .
67 years old male suffering from right lower GB sulcus carcinoma extending to left side involving gingival surface of mandible.patient was given 2 cycles of neo adjuvant chemo having partial metabolic response .Pet ct shows lesion confined to lower Gb sulcus with skin involvement .Right modified neck dissection with central arch mandibulectomy with wide excision of cheek skin with floor mouth growth excision with bilobe PM flape done.
37 years old male suffering from right buccal mucosa growth involving outer cheek skin.Upper and lower GB sulcus we are spared.Right modified neck dissection with right buccal mucosa growth excision with right lower alveolectomy with bilobe pm flape done
57 years old male suffering from buccal mucosa carcinoma reaching up to external cheek skin and involving upper Gb sulcus.CT scan shows no bony involvement.Right modified neck dissection with right lower partial maxillectomy with wide excision of right buccal mucosa growth with right PM flape done
37 years old male suffering from left level 3 neck node mass.patient was operated for left tongue carcinoma before 4 months .patient was radiated.Now patient has recurrent neck mass.Wide excision with cover of defect was done with left Pam flape.
68 years old female suffering from right breast lump .pt has strong positive h/o family breast cancer.All investigations for distant metastasis are normal.right modified MRM done.
52 years old male suffering from left buccal mucosa carcinoma with complete trismus.ct scan shows growth involving RMT and mandible.
Left level 1 big metastatic node.left modified neck dissection with left hemimandibulectomy with left PM flape done
52 years old male suffering from advance left buccal mucosa carcinoma involving mandible and upper alveolus extending to outer cheek skin.patient has extensive bilateral tuberculosis and treated with AKT for 6 months.patient has 60 % lung function capacity.Left modified neck dissection with left hemimandibulectomy with left upper alveolectomy with wide excision of left buccal mucosa growth with outer cheek skin with reconstruction by bilobe PM flape done
52 years old male suffering from right palatal carcinoma not involving infra orbital flape.
CT scan shows palatal growth involving soft palate with few subcentimezer nodes.Right level
1 to 4 neck dissection with right subtotal maxillectomy with right temporalis flape was
done.
