MGM Cancer Institute Successfully Treats 41-Year-Old Man with Advanced Inoperable Tongue Cancer
Chennai: Doctors at MGM Cancer Institute have successfully treated a 41-year-old man diagnosed with advanced tongue cancer that had earlier been deemed inoperable at multiple hospitals.
The patient, a chronic smoker, was diagnosed with squamous cell carcinoma of the tongue. The tumour, measuring approximately 5 × 3 cm with significant vertical extension, had spread across the entire anterior tongue and the floor of the mouth and had reached the hyoid bone in the upper neck, making surgical intervention extremely challenging.
Following a detailed evaluation, the multidisciplinary tumour board at MGM Cancer Institute recommended neoadjuvant chemotherapy to shrink the tumour before surgery, considering the advanced stage of the disease and the patient’s relatively young age. After two cycles of chemotherapy, follow-up PET scans showed a favourable partial response, enabling the team to proceed with definitive surgical treatment.
The patient subsequently underwent a complex composite resection, a single extensive surgery aimed at complete cancer removal. The procedure included an anterior total glossectomy (removal of the front portion of the tongue), resection of the floor of the mouth, segmental mandibulectomy to remove the affected portion of the jaw bone, and removal of the involved hyoid bone.
Following tumour removal, surgeons performed advanced free flap reconstruction to restore the structure and function of the tongue and oral cavity. Healthy tissue from the patient’s thigh was used to reconstruct the surgical defect. The patient later received adjuvant radiation therapy to eliminate any remaining microscopic cancer cells.
The treatment was carried out by a multidisciplinary team comprising Dr. M.A. Raja, Director and Senior Consultant – Medical Oncology; Dr. Sivaram Ganesamoni, Head of Department and Senior Consultant – Surgical Oncology; Dr. Manikandan Venkatasubramaniyan, Senior Consultant – Surgical Oncology; and Dr. A. Siva Kumar, Plastic Surgeon.
Commenting on the case, Dr. M.A. Raja said the patient initially presented with a persistent ulcer and abnormal growth on the tongue. “A biopsy confirmed squamous cell carcinoma, and PET scans revealed deep tumour extension up to the hyoid bone. Pre-surgical chemotherapy played a crucial role in reducing tumour burden and improving surgical outcomes,” he said.
Dr. Sivaram Ganesamoni noted that the case demonstrated the power of coordinated, multimodality cancer care. “This outcome reflects the integration of medical oncology, surgical oncology and reconstructive surgery in managing a seemingly impossible clinical scenario,” he said.
Explaining the surgical complexity, Dr. Manikandan Venkatasubramaniyan said that the reconstruction was carried out using a Free Anterolateral Thigh (ALT) flap to restore form and function. “The patient is currently disease-free and has returned to his routine life,” he added.
