A woman in her mid-50s from Mauritius was successfully treated for an extremely rare salivary gland cancer at the base of her tongue using advanced Transoral Robotic Surgery (TORS) at Fortis Hospital, Mulund. The patient was diagnosed with a 2 cm low-grade mucoepidermoid carcinoma of the minor salivary glands. This is a rare tumour type, and its presence at the base of the tongue is especially unusual.

Following detailed evaluation, the multidisciplinary team led by Dr. Rathan Shetty, Consultant  Head and Neck Surgical Oncology, Fortis Hospital, Mulund, opted for Transoral Robotic Surgery (TORS), a minimally invasive approach that enabled complete removal of the tumour through the mouth without any external incision. The robotic system provided a magnified, high definition view, allowing precise tumour excision along with an adequate margin of healthy tissue.

Post operative histopathological examination confirmed negative surgical margins, indicating complete removal of the tumour with no cancer cells at the edges of the excised tissue. Pre operative imaging and needle assessment of the neck lymph nodes also showed no evidence of metastasis, eliminating the need for neck surgery.

Traditionally, tumours located at the base of the tongue often require extensive procedures such as mandibulotomy (splitting the jawbone) or pharyngotomy (large throat incisions) to achieve adequate access. However, the robotic approach allowed surgeons to reach the tumour entirely through the mouth, reducing surgical trauma, avoiding visible scars, and facilitating faster recovery.

The patient recovered well following surgery, beginning oral liquids on the third post-operative day, and progressing to a semi-solid diet by the seventh day. She has been advised to remain in India for approximately two to three weeks for close monitoring due to the highly vascular nature of the tongue base.

Dr. Rathan Shetty, Consultant  Head and Neck Surgical Oncology, Fortis Hospital, Mulund, Mumbai, said, “Minor salivary gland cancers arising at the base of the tongue are exceptionally uncommon and require meticulous surgical planning because of the complex anatomy and the need to preserve swallowing & speech functions. Transoral Robotic Surgery enabled us to completely remove the tumour with clear margins while avoiding external incisions or more invasive procedures such as jaw-splitting surgery. Since robotic surgical

facilities are currently unavailable in Mauritius, the patient travelled to India specifically for this advanced treatment. This case highlights how robotic surgery can offer excellent oncological outcomes with quicker recovery and significantly less morbidity for carefully selected patients.”

Doctors note that the exact cause of minor salivary gland tumours remains unknown in most cases, with no clearly identifiable risk factor in the majority of patients. Early diagnosis and timely intervention remain critical in achieving favourable outcomes, particularly for rare tumours occurring in anatomically challenging locations.