Squamous cell carcinoma is the most common malignant neoplasm of the upper aerodigestive
tract, and presentation is usually at the late stages when the diagnosis is made. Recurrence
after 1st therapy is common especially in the locoregional area of the tumour. For cancers
affecting the oral cavity, oropharynx, and mandible, “COMMANDO” (Combined
Mandibulectomy and Neck Dissection Operation) is one of the surgical approaches which
constitutes of primary tumour resection, mandibulectomy and neck dissection. We describe a
case of rapid locoregional recurrence following 1st surgical procedure of bilateral tonsillectomy
and extended neck dissection of oropharyngeal squamous cell carcinoma in a young healthy
individual without history of alcohol and tobacco abuse involving the right buccal region which
after positron emission tomography was done, showed involvement of right pterygoid muscles,
right-sided tongue muscle, and right mandible. The patient underwent redo salvage surgery
and reconstruction with anterolateral thigh flap.