A two-year-old boy, suffering from a cancer considered very rare among children, lost a part of his jaw when doctors performed surgery to remove the tumour. But an eight-hour reconstructive surgery, during which a part of the boy’s calf bone was taken and attached to his jaw, has now given the child hope for a normal life. Dr Rajan Arora, who performed the surgery at the Rajiv Gandhi Cancer Institute and Research Centre, said it was the first such case he had handled. This, despite having performed approximately 500 reconstructive surgeries in the last two years. “This is a very complex reconstructive surgery, usually not performed on children. It is a rare surgery, and the first one I’ve performed on a two-and-a-half-year-old child,” Dr Arora said.
The disease the infant was suffering from, Ewing’s sarcoma, is a type of bone cancer considered very rare in paediatric oncology. The cancer usually affects those between 10 and 20 years of age. “This type of cancer itself is very rare, and it’s even more rare to see it in a child,” said Dr Shalini Mishra, consultant, paediatric surgical oncology, Rajiv Gandhi Cancer Institute and Research Centre. When the infant was examined, it was revealed that he had a localised tumour in his left jaw bone (mandible) till the mid-line. Dr Mishra said that radiation, typically used to shrink and kill cancer cells, had to be avoided.
“Radiation exposure would hamper his normal growth and have long-term side effects. So we had to opt for surgery wherein the left jaw and chin would be removed,” said Dr Mishra. But this would mean the child would have serious problems with speech and eating. “Losing the left jaw would mean he would lose his teeth. So we had to opt for reconstruction after the removal,” said Dr Mishra. For this, Dr Arora said, a “piece of the child’s fibula was taken out”. “Later, the fibula was remodelled to give it the shape of the removed lower jaw,” said Dr Arora.
“The procedure is done in adult patients suffering from oral cancer. But in children, very few such cases are reported,” Dr Mishra said. The child will be kept under observation for a year to track the growth of the jaw bone.