18/08/2026
From Maggot-Infested Advanced Oral Cancer to Definitive Cancer Surgery & Reconstruction
A challenging case of advanced T4 carcinoma of the left buccal mucosa in a 35-year-old male, presenting with a large fungating growth complicated by maggot infestation (wound myiasis).
Treatment required a carefully planned, stepwise multidisciplinary approach:
🔹 Control of myiasis with local wound care, debridement, antibiotics and antiparasitic treatment
🔹 Neoadjuvant chemotherapy (NACT) with significant reduction in tumour burden and improvement of the local condition
🔹 Definitive cancer surgery comprising Wide Local Excision + Hemimandibulectomy + Modified Radical Neck Dissection
🔹 Tracheostomy for airway management
🔹 PMMC bipaddled flap reconstruction for restoration of the complex surgical defect
🔹 At 1.5 months post-surgery, the patient is healing well and is now awaiting adjuvant radiotherapy
This case highlights an important message: even a frightening presentation of locally advanced oral cancer with myiasis should not automatically be considered beyond treatment. Appropriate infection control, systemic therapy, reassessment of resectability, definitive oncological surgery and reconstruction can provide meaningful disease control and rehabilitation in appropriately selected patients.
Early diagnosis of oral cancer can make treatment considerably simpler.
Any non-healing mouth ulcer, persistent swelling, unexplained bleeding, difficulty opening the mouth or abnormal growth lasting more than 2–3 weeks deserves specialist evaluation.
Dr. Ankit Khandelwal
Oral, Head & Neck Surgical Oncologist
Oral & Maxillofacial Surgeon
Gajanan Multispeciality Clinic, Bhowanipore, Kolkata
