PETAH TIKVA, Israel โ Physicians at Beilinson Hospital of Clalit Health Services have successfully completed one of the most complex head and neck cancer operations ever performed in Israel, removing an aggressive tumor that had invaded a patient’s skull, eye socket, facial bones, and the protective lining surrounding his brain before reconstructing his face using living bone, muscle, and blood vessels harvested from his shoulder blade.
The operation required two separate surgeries totaling more than twenty-two hours and brought together specialists in head and neck oncologic surgery, neurosurgery, maxillofacial surgery, ophthalmology, and microsurgical reconstruction.
Doctors say the procedure pushed the boundaries of modern surgical capability while preserving the patient’s ability to breathe, eat, speak, and return to everyday life.
Roman, a 50-year-old resident of northern Israel, initially sought medical attention after experiencing persistent tearing from his left eye. What appeared to be a relatively minor symptom ultimately led physicians to diagnose a rare and aggressive adenoid cystic carcinoma originating within his nasal cavity.
By the time he arrived at Beilinson Hospital, the cancer had spread extensively into his eye socket, facial skeleton, frontal bone, skull base, and dura, the protective membrane surrounding the brain.
Chemotherapy proved unsuccessful in halting the tumor’s progression toward the brain, leaving radical surgery as the only potentially curative treatment option.
“They presented us with three choices,” recalled his wife, Svetlana. “Continue treatments that weren’t working, undergo an enormous operation with tremendous risks, or do nothing and wait for him to die. We are a family that never gives up. We chose to fight.”
Surgery at the Limits of Modern Medicine
Dr. Esmat Najjar, Director of the Head and Neck Oncologic and Reconstructive Surgery Unit at Beilinson Hospital, described the operation as being among the most demanding procedures performed in his field.
“This resection was at the very edge of what is surgically possible,” he said. “Removing the cancer was only half the challenge. You cannot leave a person without a face. Our mission was not only to save his life, but to reconstruct the structures that would allow him to live with dignity and function again.”
The first operation lasted approximately twelve hours.
Surgeons removed the tumor together with portions of the frontal bone, nasal bones, cheekbones, the entire eye socket, and part of the dura to ensure complete cancer removal.
Following the procedure, Roman spent nearly two weeks recovering while physicians awaited final pathology results to determine whether all cancerous tissue had been successfully removed.
Only after laboratory testing confirmed complete tumor clearance did surgeons proceed with the second stage of treatment.
Rebuilding a Face Using Living Tissue
The second operation, which lasted approximately ten hours, focused entirely on microsurgical facial reconstruction.
Using bone, muscle, and blood vessels harvested from the patient’s scapula, or shoulder blade, Dr. Najjar and his surgical team sculpted a new facial framework. They reconstructed the forehead, cheekbones, and eye socket while restoring the protective structures surrounding the brain.
The transplanted tissue was connected to blood vessels in the patient’s neck using advanced microsurgical techniques, allowing the reconstructed structures to remain alive and capable of healing during the intensive radiation treatments that will follow.
“His eye was essentially left without a socket to support and protect it,” Dr. Najjar explained. “We had to build it a new home. At the same time, we had to recreate the protective barrier over the brain, restore the facial skeleton and make it possible for him to breathe, eat, speak and walk outside without feeling that he had to hide.”
The use of living tissue provides significant advantages over artificial implants or grafts, particularly for patients requiring subsequent radiation therapy. Living bone and muscle are more capable of healing and adapting during treatment while improving long term functional outcomes.
A Rare and Aggressive Cancer
According to Dr. Noga Kurman, Head of the Head and Neck Cancer Service at Beilinson Hospital’s Davidoff Cancer Center, Roman’s diagnosis represented an exceptionally rare presentation of adenoid cystic carcinoma.
The malignancy originated from salivary glands located within the nasal cavity before spreading aggressively into surrounding structures.
“When chemotherapy failed, we faced an extremely difficult decision,” she said. “This type of cancer has very limited effective systemic treatment options, making radical surgery the only chance for cure. Watching so many specialties come together to offer this patient that opportunity was truly extraordinary.”
The case required close collaboration among multiple medical disciplines at every stage of treatment planning and execution.
Hospital officials noted that successful outcomes in cases of this complexity depend upon seamless coordination between surgical oncologists, neurosurgeons, reconstructive specialists, pathologists, and cancer treatment teams.
Looking Forward
Roman has now returned home and is breathing, eating, and drinking independently.
He is expected to travel abroad in the coming weeks to receive particle beam radiation therapy designed to eliminate any microscopic residual disease that may remain following surgery.
For his family, however, the greatest success is much simpler.
“For me, it doesn’t matter what he looks like,” said Svetlana. “I love him exactly the same. The only thing that matters is that he is alive.”
The extraordinary operation highlights both the advances of modern reconstructive surgery and the capabilities of multidisciplinary cancer care. What began as persistent tearing from one eye became a battle against an aggressive and life-threatening cancer that demanded one of the most challenging surgical procedures performed in Israel.
Today, Roman’s ability to breathe, eat, speak, and return home stands as a testament not only to medical innovation, but also to the determination of a family that refused to surrender hope when faced with impossible choices.
