Late detection after 4 months of prolonged pain and tongue ulcers
Patient N.V.V (33 years old, residing in Lao Cai) was admitted to the hospital in a state of pain and tongue ulcers lasting about 4 months. The patient self-treated with oral and topical medication but did not improve.
When examined at K Hospital, doctors discovered a swollen tumor in the oral cavity on the right side of the tongue. Examination and paraclinical results determined that the patient had squamous carcinoma - a form of cancer originating from surface cells of the tongue.
The MRI results of the jaw and face recorded a tumor with a size of about 26x10mm. Pathological examination determined grade 2 invasive keratochondrial carcinoma. Notably, the patient did not record neck lymph node metastasis or distant metastasis, diagnosed in stage II.
Dr. Ngo Xuan Quy - Head of Head and Neck Surgery Department - said that this is a stage with a high possibility of radical treatment, with a survival rate of 70-80% if treated according to the correct protocol.
Microsurgery application: tongue regeneration and preserving vital function
Dr. Ngo Xuan Quy added that tongue cancer is one of the common oral cavity cancers but is easily confused with common mouth ulcers, causing many patients to be subjective.
In this case, the professional council agreed on a plan: cutting and selling the right tongue combined with neck-right lymph node dissection.
The principle of tongue cancer treatment is to have extensive cuts, ensuring a clean cut area to limit recurrence. In particular, this type of cancer is less responsive to chemotherapy and radiation therapy, so surgery plays a decisive role," said Dr. Quy.
However, tongue surgery is one of the difficult techniques due to its complex anatomical structure, rich in blood vessels and nerves. Ensuring both removing all cancer damage and preserving speech, swallowing and sensory functions is a major challenge for the surgical team.
In parallel with tumor removal, cervical lymph node dissection is performed to eliminate the risk of mitochondrial metastasis, even when no lesions have been detected in imaging.
After removing a part of the tongue, the patient faces a large gap in the oral cavity, which can cause deformation, difficulty speaking, difficulty swallowing if not properly reconstructed.
To solve this problem, doctors have applied modern microsurgery plastic surgery techniques. This is a method of using endogenous tissue (in this case, a braid) to regenerate the missing tongue.
Under a surgical microscope, doctors proceeded to connect blood vessels and microstructures of the tissue patch to the neck area's vascular system, helping to maintain tissue culture.
The tissue patch is designed to ensure the function of tongue movement, maximizing support for eating, speech, and limiting deformity of the oral cavity after surgery. In particular, patients do not need tracheostomy during treatment.
The surgery took place smoothly thanks to the close coordination between the surgical team, anesthesia resuscitation and postoperative resuscitation. After surgery, the patient recovered well, no severe complications were recorded.
After only 5 days, the patient was able to eat and drink through the mouth and communicate relatively clearly.
