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News Americas

Pre-surgical scans of the patient showing a large tumor that had spread throughout the lower third of his face. (Photo: Henry Ford Hospital, USA)
Sep 17, 2012 | News Americas

Head and neck surgeons remove rare facial tumor

by Surgical Tribune

DETROIT, Mich., USA: Surgeons from the Henry Ford Hospital in Detroit have removed a very aggressive bone tumor that had spread throughout the entire lower third of a 21-year-old patient's face. Using a new surgical technique, they were able to rebuild a fully functional jaw and mouth and preserve the patient's ability to eat and speak successfully.

Usually, metastasis of osteosarcoma is found in the long bones and rarely spreads to other parts of the body, the surgeons stated. However, in the present case, the osteosarcoma spread from the patient's right femur to his mandible. According to their case report, the patient had undergone multiple treatments, including mandible resection, radiation, chemotherapy and cryosurgery, before presenting to the hospital.

In a 20-hour surgery, the doctors had to remove large parts of the patient's mandibular bone, his entire tongue, mucous membrane from the inside of both cheeks and his entire lower lip. In the same procedure, they performed a complex reconstruction of the face and jaw using dual microvascular free flaps from his leg and shoulder area, a technique that offers the opportunity to reconstruct large massive bone and soft-tissue defects to maintain full function that would otherwise take several surgeries.

"The reconstruction involved bone and skin transplanted from the patient's left leg and tissue complex from his shoulder blade area with its feeding blood supply comprised of multiple islands of skin and muscles to reconstruct all of the tissues," said Dr. Tamer A. Ghanem, director of the hospital's Head and Neck Oncology and Microvascular Surgery Division.

Only three months after the surgery, the patient was able to talk and eat without assistance, the hospital announced.

Osteosarcoma is the second most common primary malignant bone tumor and the eighth most common childhood cancer in the U.S. According to the American Cancer Society, about 800 new cases are reported each year and about 400 of these are in children and young adults. This type of cancer develops in areas in which the bone is growing quickly, such as near the ends of the long bones. Thus, it occurs mostly in tall children and adolescents and males in particular.

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