A 61-year-old man was admitted to the hospital in early February, severely emaciated and in intense pain due to recurrent nasal cavity cancer. One year prior, the patient had undergone surgery for a malignant sinonasal tumor combined with chemotherapy and radiation therapy, but the tumor had progressed rapidly.

On March 4, Doctor Hoang Ba Dung, Head of the Department of Otorhinolaryngology at Cho Ray Hospital, reported that the tumor had grown into a large mass on the left side of the face. The tumor had invaded through the skin, spread throughout the left eyeball, destroyed the maxilla, infiltrated the palate, and extended deep into the brain. The patient endured piercing pain that radiated to his head, preventing him from eating or sleeping, and leaving him physically and mentally exhausted.

Cho Ray Hospital initiated a multi-specialty consultation involving Otorhinolaryngology, Neurosurgery, Ophthalmology, Plastic and Aesthetic Surgery, and collaborated with the National Hospital of Odonto-Stomatology. Assessing that there was still a chance to save the patient's life, doctors decided to proceed with surgery, involving dozens of medical professionals.

Teams took turns entering the "battle." First, otorhinolaryngologists, in coordination with the National Hospital of Odonto-Stomatology, resected a tumor weighing nearly 800 grams from the left maxilla and palate. Immediately after, ophthalmologists intervened, removing the entire left eyeball, which had been completely destroyed by cancer cells. The neurosurgery team then performed a craniotomy to remove the tumor that had invaded the brain.

Doctors operating on the patient. Photo: Hospital provided

After many hours of extensive tumor resection, the patient's life was temporarily saved, but he faced a massive defect on his face. At this point, the plastic and aesthetic surgery team performed a microsurgical free flap transfer from the leg to cover the eye socket, reconstruct the nasal septum to preserve the airway, and reshape the palate to separate the oral cavity from the nasal cavity.

The major surgery concluded successfully after 10 hours of intense effort, requiring four units of blood. After two weeks of intensive treatment, the patient was discharged in stable condition. During a follow-up examination in early March, his health had significantly recovered; he could walk independently, breathe through his nose, speak clearly, and was in good spirits. The covering skin flaps were healthy, the wounds had healed well, and the severe pain had completely disappeared. The patient had his feeding tube removed and could eat and drink normally by mouth.

Doctor Dung examining the patient post-surgery. Photo: Hospital provided

According to Doctor Dung, late-stage nasal cavity cancer cases with extensive invasion are often only indicated for palliative treatment due to the impossibility of radical surgery, making successful intervention like this case very rare. This was the first time the hospital collaborated simultaneously with many specialized departments in a 10-hour surgery. This approach maximized the "golden hour," shortened treatment time, reduced complications from multiple anesthesias, and optimized recovery outcomes.

Doctors advise cancer patients post-surgery to adhere to regular follow-up appointments to detect any abnormalities early, increasing the chance of timely intervention.

Le Phuong