General Anesthesia for Wide Excision + Flap Procedure

Abstract

Malignant peripheral nerve sheath tumor (MPNST) is a rare and aggressive soft tissue malignancy with a high risk of local recurrence, requiring wide excision with adequate margins followed by reconstructive procedures. Anesthesia management in head and neck oncologic surgery presents specific challenges related to airway control and hemodynamic stability. This article reports the anesthetic management of a 57-year-old male patient diagnosed with a malignant peripheral nerve sheath tumor in the right parietal region who underwent wide excision and flap reconstruction under general anesthesia using a laryngeal mask airway (LMA). Pre-anesthetic evaluation classified the patient as ASA physical status II with no significant systemic comorbidities. Anesthesia was induced with propofol and fentanyl, and airway management was achieved successfully using an LMA. Intraoperative monitoring demonstrated stable hemodynamic parameters and adequate oxygenation throughout the procedure. Postoperative recovery was uneventful, with good pain control and no airway-related complications. This case demonstrates that general anesthesia with LMA can be a safe and effective airway management option for selected head tumor surgeries with low aspiration risk and moderate operative duration