• SeHo Shin, KiHyun Kim, SangSeok Woo, KyungMin Kim, JunWon Lee, SeongHwan Kim, JaiKoo Choi, DongJin Lee, and InSuck Suh.
• Department of Plastic and Reconstructive Surgery, Kangnam Sacred Heart Hospital, College of Medicine, Hallym University, Seoul, Korea.
• Medicine (Baltimore). 2023 May 26; 102 (21): e33786e33786.

RationaleAlthough regional metastasis to the lymph nodes is common in advanced oral cancer, extensive local invasion into surrounding structures such as the mandible, skin and soft tissue of the neck, and masticator space is relatively rare. Sometimes surgical treatment cannot be performed and only palliative chemotherapy and radiation therapy are offered to preserve the quality of life of patients with advanced oral cancer. Nevertheless, the surgical resection of tumors remains the most effective treatment. This study presents a case of aggressive mouth floor cancer in which extensive composite defects on the mouth floor, oral mucosa, mandible, skin and soft tissue of the neck caused by tumor resection were reconstructed.Patient ConcernsA 66-year-old man and a 65-year-old man with no significant personal or family history visited our clinic due to a large and multiple masses on the floor of the mouth and both sides of the neck.DiagnosisHistopathological evaluation of the biopsy specimen revealed squamous cell carcinoma.InterventionsA fibula osteocutaneous free flap and customized titanium plate were used for the intraoral lining. Mandibular reconstruction was performed using a 3D-printed bone model, and an anterolateral thigh free flap was used to resurface the anterior of the neck.OutcomesReconstruction using this method was successful, and excellent functional and aesthetic outcomes were achieved without cancer recurrence.LessonsThis study show that the reconstruction of extensive composite defects of the oral mucosa, mandible, and neck soft tissue following surgical resection of mouth floor cancer can be performed in a single-stage operation. Through a single-stage reconstruction, both excellent functional aspects without cancer recurrence and satisfactory aesthetic outcomes can be obtained.Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.

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