Congenital bifid tongue with cleft palate is a very rare malformation with different variations. We are reporting 2 cases of rare congenital bifid tongue with cleft palate in our hospital setting and their surgical management. A multidisciplinary approach, well-planned staged operations, rehabilitation, and follow-up are needed to achieve favorable outcomes.

Extensive chest wall tumor resection and reconstruction possess a formidable challenge and require good collaboration between thoracic and reconstructive surgeons. In this article, we reviewed our experience in six consecutive cases requiring complex chest wall resection and reconstruction with titanium rib plates and free anterolateral thigh fasciocutaneous flap with fascia lata with a minimum 24 months follow-up postoperatively.Six patients with a mean age of 54 were diagnosed to have locally advanced malignant (n = 5) and benign (n = 1) tumors. They underwent wide local excision with a mean of six ribs resected, and the average size of the soft tissue defect was 389cm2. The integrity of the thoracic cage was restored by using titanium rib plates. Fascia lata was harvested along with free anterolateral thigh fasciocutaneous flap to achieve near airtight closure of pleural space for soft tissue coverage. Two patients required early flap exploration with successful flap salvage. One flap failure was reported on postoperative day 11 due to a mechanical cause and a redo surgery was required. With an average stay of 3 days in the intensive care unit, no perioperative pulmonary complications were recorded.Complex oncological chest wall resection and reconstruction with titanium rib plates and free anterolateral thigh fasciocutaneous flap with fascia lata yielded satisfactory aesthetic and physiological functional outcomes.

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Background Majority of cutaneous squamous cell carcinoma (cSCC) originate in the head and neck region, with 1–3% have been found to have parotid or periparotid lymph nodes metastases. The significance of secondary parotid metastases from cSCC lies in its propensity of cervical lymph node spread and distant metastases leading to a dismal prognosis, and therefore the importance of early diagnosis and prompt treatment. Case Description An 85-year-old gentleman with prior history of right temporal squamous cell carcinoma (SCC) presented with a new onset left cheek cSCC. He underwent complete excision with clear margin. Four months following initial surgery, he developed ulcerative mass at left angle of mandible. CT scan revealed an underlying left parotid gland tumor, which was confirmed to be SCC by fine needle aspiration cytology (FNAC). He was then surgically treated with nerve-sparing total parotidectomy, modified radical neck dissection, soft tissue reconstruction using free anterolateral thigh fasciocutaneous flap and adjuvant radiotherapy with satisfactory outcomes. Conclusions Although rare, metastatic cutaneous SCC to parotid gland represents a unique group of locally advanced cutaneous SCC. Multimodal treatment approach consisting of total parotidectomy, ipsilateral neck dissection and adjuvant radiotherapy has been shown to improve the locoregional control of the disease and limit the propensity to distant metastasis.