Case Report
Successful Awake Nasal Intubation for Difficult Airway Management in a Postpartum Woman Who Presented with Left Mandibular Soft Tissue Sarcoma: A Case Report
Tesfaye Asefa Hordofa*
,
Minda Abebe Selfie,
Yusuf Ahmed Kedir,
Ebrahim Ahmed Hussein
Issue:
Volume 7, Issue 2, June 2026
Pages:
23-28
Received:
3 June 2026
Accepted:
15 June 2026
Published:
17 July 2026
DOI:
10.11648/j.wjmcr.20260702.11
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Abstract: Background: Soft tissue sarcomas (STSs) are rare malignancies. This type of tumor can cause airway obstruction, anatomical distortion, voice changes, and limitations in opening the mouth, which may complicate intubation or ventilation. Difficult airway management in oral and maxillofacial surgery focuses on maintaining airway reflexes and spontaneous breathing. This case report describes a novel approach to awake nasal intubation in a postpartum woman with left mandibular soft tissue sarcoma. Unlike previous studies that relied on ultrasound or bronchoscopic guidance for awake intubation, this report describes successful blind awake intubation using a transtracheal block. Case presentation: This is a 20-year-old gravida I, para I woman who presented with swelling on the left side of her face for five months. She presented with these symptoms 3 weeks after spontaneous vaginal delivery. The swelling started on the buccal mucosa as a small lesion prior to delivery. After the airway was anesthetized with 5 ml of 2% lidocaine gargle and 5 ml of 2% lidocaine injected through the cricothyroid membrane, awake, blind nasal intubation was successfully conducted. Conclusion: Effective management of difficult airways requires a well-planned strategy, multidisciplinary team discussion, and preoperative assessment. This case report contributes to the literature by demonstrating successful awake blind nasal intubation facilitated by a transtracheal block using 5 ml of 2% lidocaine administered at the cricothyroid membrane. In situations with limited resources, awake blind nasal intubation with a transtracheal block can be a valuable and practical technique for managing difficult intubations. However, it requires a trained and experienced anesthetist.
Abstract: Background: Soft tissue sarcomas (STSs) are rare malignancies. This type of tumor can cause airway obstruction, anatomical distortion, voice changes, and limitations in opening the mouth, which may complicate intubation or ventilation. Difficult airway management in oral and maxillofacial surgery focuses on maintaining airway reflexes and spontaneo...
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Case Report
A Rare Documented Case of Advanced Metastatic Dermatofibrosarcoma Protuberans (DFSP) with Extensive Intrathoracic Dissemination
Asmell Ramos Cabrera*,
Hector O. Victoria Barzaga,
Jennifer Shallop,
Momodu Kabir Manneh,
Syeda Qurat-ul-Ain Hasan,
Al-Heri Bulus Mika
Issue:
Volume 7, Issue 2, June 2026
Pages:
29-33
Received:
1 July 2026
Accepted:
21 July 2026
Published:
27 August 2026
Abstract: Background: Dermatofibrosarcoma protuberans (DFSP) is a rare, locally aggressive cutaneous soft-tissue sarcoma characterized by low metastatic potential. However, rare fibrosarcomatous transformation (FS-DFSP) significantly increases the risk of systemic spread; although metastases—particularly pulmonary ones—are infrequent compared to other skin tumors, they have been sporadically described in the medical literature. Objective: This report documents a rare clinical case of extensive intrathoracic dissemination secondary to advanced metastatic progression in an elderly patient with a long-standing history of recurrent DFSP managed in a resource-constrained setting and the first documented primary pulmonary metastasis in the Gambia. Methods: We conducted a retrospective clinical analysis of an 81-year-old male presenting with severe, progressive dyspnea following a 14-year history of recurrent, histologically confirmed DFSP across the limbs and torso. The evaluation involved a comprehensive clinical examination, review of historical dermatological records, and detailed thoracic imaging to establish the extent of visceral involvement. Results: Clinical and radiological evaluations revealed massive intrathoracic tumor burden consistent with pulmonary and pleural metastases originating from the transformed cutaneous sarcoma. Despite the indolent initial presentation of DFSP, the development of late-stage visceral dissemination underscores the aggressive biological potential of the tumor over extended timelines. Managing this complex presentation was further compounded by limited local diagnostic and therapeutic resources. Conclusion: This case highlights the critical necessity for long-term clinical vigilance regarding indolent dermatological conditions, outlines the diagnostic challenges in linking chronic skin lesions to visceral metastasis, and emphasizes the urgent need for improved diagnostic pathways, heightened surveillance, and multidisciplinary care models to effectively manage complex soft-tissue sarcomas in resource-limited environments.
Abstract: Background: Dermatofibrosarcoma protuberans (DFSP) is a rare, locally aggressive cutaneous soft-tissue sarcoma characterized by low metastatic potential. However, rare fibrosarcomatous transformation (FS-DFSP) significantly increases the risk of systemic spread; although metastases—particularly pulmonary ones—are infrequent compared to other skin t...
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