Patient Overview

Patient Overview

Oral Cavity and Tongue Cancer Treatment by Prof. Dr. Ashequr Rahman Bhuiyan

Patient Profile:

• Name: Mr. Z (pseudonym)
• Age: 60
• Gender: Male
• Medical History: Long-term smoker and occasional alcohol consumption. No significant family history of cancer.

Presentation:

• The patient presented with persistent pain and a non-healing ulcer on the left side of his tongue, which had been present for approximately 2 months.
• He also reported difficulty swallowing (dysphagia) and occasional bleeding from the ulcer.
• Upon further questioning, the patient mentioned a gradual loss of sensation on the left side of his tongue.

Clinical Examination & Diagnostics:

• Physical Examination:
  • A large ulcerated lesion was noted on the left lateral aspect of the tongue, with irregular borders and raised edges.
  • There was slight tenderness on palpation, and enlarged cervical lymph nodes were palpable on the left side.
  • No signs of facial nerve involvement were observed.
• Imaging & Biopsy:
  • CT Scan of the head and neck revealed an extensive tumor involving the tongue and extending towards the floor of the mouth.
  • Biopsy of the lesion confirmed the diagnosis of Squamous Cell Carcinoma (SCC) of the tongue.
  • PET-CT scan was performed to assess the spread of cancer to other areas, which showed involvement of regional lymph nodes but no distant metastasis.

Treatment Plan:

• Surgical Intervention:
  After a detailed discussion with the patient, the treatment plan was decided to involve a wide local excision of the tumor along with neck dissection to remove the affected lymph nodes. Prof. Dr. Ashequr Rahman Bhuiyan, renowned for his proficiency in minimally invasive surgeries, conducted the operation, ensuring the complete removal of the tumor with adequate margins.
  • Tongue Resection: The affected portion of the tongue was removed, and the surgical area was reconstructed using a flap from the cheek to ensure the restoration of the tongue's function.
  • Neck Dissection: The lymph nodes in the left side of the neck were also removed to prevent metastasis.

Post-Surgery Care:

• The patient was closely monitored for complications such as bleeding, infection, or airway obstruction.
• Pain management and nutritional support were provided to assist in recovery and speech function.
• The patient was referred for adjuvant radiotherapy to reduce the risk of recurrence and to target any residual cancer cells.
• Follow-up visits were scheduled to monitor healing, speech, and swallowing function.

Outcome:

• The patient recovered well after surgery, and his pain was significantly reduced.
• Post-operative radiotherapy was completed without complications.
• Follow-up imaging and physical exams showed no evidence of recurrence in the tongue or lymph nodes.
• The patient regained most of his speech and swallowing functions after rehabilitation.

Conclusion:
This case highlights the importance of early diagnosis and timely surgical intervention in oral cavity and tongue cancer. Prof. Dr. Ashequr Rahman Bhuiyan’s expertise in performing bleeding-free surgeries and his careful approach to tumor resection and lymph node management were pivotal in ensuring the patient's recovery and long-term survival. His advanced techniques in surgical reconstruction also contributed to restoring the patient’s oral function and quality of life after surgery.