Text/Yangcheng Evening News all-media reporter Zhang Hua Correspondent Zhang Yang Huang Rui
The 57-year-old Aunt Zhong suffered from basal cell carcinoma on the left eyebrow for 21 years, and due to the deterioration of her condition, "half of her face" and even the flesh and bones were "eaten" by the tumor, becoming a "horror film ghost face". Recently, the team of Professor Zhang Jinming of the Department of Plastic Surgery of Sun Yat-sen Memorial Hospital of Sun Yat-sen University successfully completed the ultra-difficult "face repair" for Aunt Zhong, reconstructing her face while removing the lesions. After the operation, Aunt Zhong recovered smoothly and was discharged from the hospital a few years ago. This year's New Year, Aunt Zhong, who got rid of her "scary face", can finally hug her granddaughter with confidence!
A small mass on the arch of the eyebrow, growing into a large tumor that eats the face
In 2000, a "black mole" the size of a grain of rice suddenly grew above the arch of Aunt Zhong's left eyebrow, and after a period of time, the black lump remained unresolved. Aunt Zhong went to the local hospital for local mass resection, and through histopathological biopsy, it was found that the original "small black mole" was the infamous basal cell carcinoma (referred to as "basal cancer"). For the sake of insurance, Aunt Zhong immediately came to a hospital in Guangzhou for extended resection. But the hidden dangers are still buried.
In 2008, Aunt Zhong found that the tumor recurred at the arch of the left eyebrow, and soon the tumor grew to about 4* 3 cm in size. Aunt Zhong went to the dermatology department of a hospital and carried out 7 "photodynamic treatments", but the effect was not good. In desperation, Aunt Zhong underwent "skin tumor resection" again, and did not undergo adjuvant radiotherapy and chemotherapy after surgery.
In 2011, the original tumor recurred again, and the itching was severe. Aunt Zhong received "excimer treatment" for more than 1 year, but the effect was not good. Frustrated, Aunt Zhong chose palliative care and returned to Jiangmen.
Unexpectedly, Aunt Zhong's tumor continued to enlarge, affecting the left frontal area, eyes, and maxillofacial area, accompanied by pain, itching, ulceration, pus, and compression of the left eye, and gradually decreased vision. In 2019, Aunt Zhong eventually went blind in her left eye.
The desire to "live" was rekindled, but the condition deteriorated rapidly
Two years ago, Aunt Zhong's granddaughter was born. The arrival of this little angel made the originally disheartened Aunt Zhong rekindle her desire to live, and decided to further treat and live for a few more years to accompany this little cute. In 2021, Aunt Zhong went to a hospital in Guangzhou again and underwent 34 radiotherapy, 8 chemotherapy and 4 targeted therapies.
But God seemed to have made a big joke with her. More than two months ago, Aunt Zhong's condition suddenly and rapidly deteriorated, and the facial mass on the left side of the face gradually festered and a large amount of pus flowed, affecting the left frontal, eye, maxillofacial, oral and tongue, and the pain was severe. When Aunt Zhong was desperate, she listened to the "earthwork" and used the "elephant powder" externally on her own, the ulcer aggravated, and a huge defect was formed on the face, and the "half of the face" was even eaten with bone and flesh. This not only destroys the appearance, but also accompanies the stench, and even affects the function of eating. For more than two months, Aunt Zhong had difficulty eating, and she could only break the food with a wall breaker and then carry out a liquid diet, with poor spirits and sleep, and a poor quality of life.
After several turns, Aunt Zhong admired Professor Zhang Jinming, director of plastic surgery at Sun Yat-sen Memorial Hospital of Sun Yat-sen University, for treatment. After seeing Aunt Zhong's situation, Professor Zhang Jinming decided to perform surgery on her and do his best to help her alleviate her pain and improve her quality of life.
MDT multidisciplinary expert escort, took 12 hours to successfully "repair the face"
After Aunt Zhong was admitted to the hospital, Sun Yat-sen Memorial Hospital of Sun Yat-sen University gave full play to the advantages of the general hospital, organized multidisciplinary consultations in many specialties such as plastic surgery, radiology, anesthesia, neurosurgery, otolaryngology, etc., and formulated a suitable surgical plan for Aunt Zhong.
On December 29, 2021, Professor Zhang Jinming, together with Professor Huang Xiaoming, Director of the Department of Otolaryngology, and Dr. Xie Lin, Department of Neurosurgery, performed a widening resection of the left maxilla, resection of the left orbital contents, resection of the left frontal lobe lesion, resection of the left frontal bone lesion, enlarged resection of left maxillofacial basal cell carcinoma, free latissimus dorsal flap resection, repair of maxillofacial defects, island flap transplantation + nasopharyngeal reconstruction, and full thick skin flap resection of the right abdominal wall. Due to the extreme difficulty of the operation, the operation took 12 hours and 30 minutes, and lasted from 10:00 a.m. to 10:30 p.m.
According to Professor Zhang Jinming, Aunt Zhong's case is rare in the world, the difficulty of surgery is unparalleled in the world, and there are few hospitals in the world that have the ability to pick up and are willing to take such cases. The range of tumors and infections is enormous, from the frontal sinuses and the base of the skull to the soft palate and teeth, to the skin of the face, and back to the anterior edge of the first and second cervical vertebrae. The defect caused by the tumor also exceeds the midline of the face, and there are a large number of very important blood vessels, nerves and organs in this range, and a slight negligence during the operation will cause irreparable huge losses, and even a great danger to life.
Therefore, the operation was done in a "relay race" manner. The resection and debridement of necrotic tissue and tumor tissue is completed by doctors in otolaryngology and neurosurgery, followed by further excision of tumor tissue by plastic surgeons, the acquisition of latissimus dorsi flap, and finally facial reconstruction through free latissimus dorsi flap transplantation. The operation was presided over by 5 batches of doctors under the auspices of Professor Zhang Jinming, and it took 12 and a half hours to complete smoothly and safely.
The good news is that on January 5, 2022, Aunt Zhong was successfully transferred from the ICU to the general ward of plastic surgery for further treatment, and on January 17, the tracheal catheter was removed, and the gastric tube was removed the next day for oral feeding. Then Aunt Zhong recovered well and could walk on the ground. After the operation, Aunt Zhong said: "Thank you Professor Zhang Jinming and Sun Yat-sen Memorial Hospital of Sun Yat-sen University for my treatment. In the past few months, I have really lived 'people are not people, ghosts are not ghosts', and the monsters in the movie may not be as scary as me! I didn't dare to go out to meet people, half of my face was wrapped in three layers and three layers, and even I couldn't hide the smell of my body, I didn't dare to get too close to people, even my beloved granddaughter, I didn't dare to get close, let alone the pain of the bone. ”
Aunt Zhong said that after Professor Zhang Jinming's treatment, her face was not as painful as before, her face was not smelly, she could sleep at night, and more importantly, she finally "changed her face" to see people again, and she could finally hug her granddaughter this year.
Professor Zhang Jinming introduced that basal cell carcinoma is one of the most common malignant tumors of the skin on the surface of the body, which has a certain relationship with sunlight exposure, and is more likely to occur on the face, scalp, neck and other parts. In general, a better prognosis treatment can be obtained through surgical resection, and surgical resection advocates complete resection and cannot be tolerated because of difficult repair. If the resection is not complete, there is still a certain probability of recurrence of "basal cancer", but it is rare for a case like Aunt Zhong to recur repeatedly and lead to such a huge destruction, and she has taken many detours in the treatment process, which is also the main reason why the face is "eaten". Therefore, Professor Zhang Jinming suggested that patients with "basal cancer" should undergo standardized and reasonable surgical treatment in the early stage of onset.
"Like this kind of difficult surgery, our department has some recent surgery, such as a congenital penile-free patient penile reconstruction surgery some time ago, and a case of tumor resection surgery in a patient with a huge lymphoma of the right hip and right thigh in Corey. We in plastic surgery have the ability and willingness to undertake such difficult surgeries and play a public and inclusive role in plastic surgery in public hospitals. While assuming social responsibility, I also hope that by taking over these difficult surgeries, I will do a good job of 'Yixian Doctor' and tell the 'Yixian Story'. Zhang Jinming added.
Editor: Lin Qingqing