Surgeons give a facelift to man after removing massive 5.3 kg cancerous tumour from his jaw The patient’s lower jaw was reconstructed using his leg bone

Surgeons give a facelift to man after removing massive 5.3 kg cancerous tumour from his jawThe patient’s lower jaw was reconstructed using his leg bone

Video Link:- https://youtu.be/vIOh7VHxwlo

Sagaya Fernando

Mumbai: 30 November 2018

Before

With people in his vicinity ridiculing him for the abnormal growth on his face, Majeed N, a 45-year-old father of four school-going children from Palakkad in Kerala, India, was forced to live a secluded life, hiding his face from the world for the past ten years. He had cancer affecting the left side of his lower jaw that resulted in a jaw tumour so large, rarely found in medical literature. Majeed had chondroblastic osteosarcoma (COS) that occurs predominantly in the head and neck regions. Osteosarcomas of the jaws are rare with an estimated incidence of 1 case per 1,00,000 persons per year.

After

Majeed’s life changed for the better a few days ago when a team of 12 surgeons at Kochi’s Amrita Institute of Medical Sciences (Amrita Hospital) removed the humongous deformity – weighing a whopping five kilos and measuring 20 x 15 x 10 cm – in a surgery that lasted 12 hours.

The tumour started growing on Majeed’s lower jaw in 2008 and protruded out to the left. The dense collection of bone and fibrous tissue led to a grotesque appearance of his face and enormous difficulty in swallowing and speaking, in addition to the social stigma. From being a social activist loved by all for his willingness to help people, he became a recluse and stayed confined to his house. He and his family became dependent on the benevolence of others even for the basic needs of life, as he could not go to work and people began making fun of his appearance.

“Majeed was treated at a cancer centre in Kerala where a part of his jaw was removed. However, there was a recurrence of the disease two years later and he had to undergo yet another surgery. He did well for some time but developed the disease on the other side of the jaw three years ago. Since the disease was extensive and reconstruction difficult, he was suggested palliative chemotherapy. Despite continuing with chemotherapy for several cycles, the swelling on his face continued to enlarge, making his life unbearable. That is when Majeed heard of a similar surgery done at our hospital, and decide to consult us”, said Dr Subramania Iyer, Chairman and Professor, Plastic Surgery and Head & Neck Surgery, Amrita Institute of Medical Science, Kochi, who led the team of surgeons.

“Majeed underwent a PET CT scan to determine the extent of the spread of the disease. Since it was found confined only to the jaw, we had extensive discussions with our tumour board and considered curative treatment for the patient. Majeed and his family decided to go for surgery despite being advised that the results may not be very good in the long term regarding disease control or having a good cosmetic and functional outcome,” said Dr Iyer, stressing that this is one of the largest ever reported lower jaw tumours of its kind.

“The huge mass was leading to grave complications. If the condition had persisted, Majeed would have found it impossible to use his mouth. The removal of the tumour, as well as reconstruction of the lower jaw, was a great challenge,” claimed Dr Iyer.

Surgeons had to carry out the procedure without endangering Majeed’s life. It involved detaching the tumour from the skull bone and keeping the reconstructed jaw in place.

“The tumour’s removal was complicated due to its huge size and the involvement of the entire lower jaw. The amount of blood loss was a cause of worry, but this was controlled by temporarily blocking blood vessels to that part of the face. The tumour including the entire remaining lower jaw was removed on July 24 this year. Reconstruction was meticulously planned. Micro-surgical transfer of Majeed’s leg bone was carried out to construct a new lower jaw. The patient regained the function of normal eating and talking within a span of three weeks after surgery. The surgeons reconstructed his lips and he was discharged on August 28,” said Dr Iyer.

Majeed’s tumour has been removed fully and he was on chemotherapy for the next two months to prevent it from coming back.

A relived Majeed had to say, “Due to the huge deformity on my face, my whole life had collapsed. I began staying indoors as people made fun of me. It is a huge relief to get the tumour off my face – it is almost like a second birth.”