Tracheostomal recurrence in oral squamous cell carcinoma: a case report and literature review

Tracheostomal recurrence is a rare but serious complication following temporary tracheostomy in oral cancer patients, with an estimated incidence of ∼1%. It is typically associated with poor prognosis, as most patients succumb to disease within months of recurrence. This report concerns a 61-year-old male with advanced squamous cell carcinoma of the right retromolar trigone (pT4bN3b, American Joint Committee on Cancer, 8th edn). Following segmental mandibulectomy, modified radical neck dissection, and adjuvant chemoradiotherapy, the patient developed a squamous cell carcinoma recurrence at the previous tracheostomy site 5 months later. He underwent wide excision with pectoralis major myocutaneous flap reconstruction, followed by systemic therapy including nivolumab. At 5 years of follow-up, he remains disease-free with preserved daily activities. Unlike most reported cases, which are associated with dismal outcomes, our patient achieved long-term disease-free survival after multimodal salvage therapy. This case underscores the importance of early detection, aggressive surgical management, and the potential contribution of immunotherapy in improving outcomes. Preventive measures during tracheostomy and vigilant surveillance are essential to minimize recurrence risk.