Oral Squamous Cell Carcinoma of the Mandible with Management of Wide Excision, Right Hemimandibulectomy, Mandibular Reconstruction, and Pectoralis Major Myocutaneus Flap: A Rare Case Report
Joko Wibowo Sentoso *
Department of Surgery, Faculty of Medicine, Sebelas Maret University / Dr. Moewardi Hospital, Surakarta, Indonesia.
Widyanti Soewoto
Sub Oncology Surgery, Department of Surgery, Faculty of Medicine, Sebelas Maret University / Dr. Moewardi Hospital, Surakarta, Indonesia.
*Author to whom correspondence should be addressed.
Abstract
Aims: To report the case of a man diagnosed with mandibular mucogingival SCC and present its case details, histopathological findings, and management.
Presentation of Case: A 35-year-old man with complaints of lumps and a wound on the right side of the face that has been getting bigger since 9 months ago. The lump initially appeared the size of a marble on a loose tooth mark, then quickly grew to the size of tennis ball within a month. Physical examination revealed mass in the facial and colli region, ulcerated, solid, fixed, multiple masses of varying size. The first biopsy examination showed epulis pyogenic, an interval of one month and the biopsy examination showed well-differentiated squamous cell carcinoma. The patient was treated with Mandibular Reconstruction surgery, Pectoralis Major Myocutaneus Flap, Wide Excision, and Hemimandibulectomy Dextra.
Discussion: Clinically, the possibility of misdiagnosing can occur due to various manifestations. SCC of the gingiva is often asymptomatic and the initial symptoms are usually an intraoral mass or swelling, ulceration, pain, ill-fitting dentures, tooth mobility, or an extraction wound that does not heal. These tumors often resemble inflammatory lesions affecting the periodontium. Treatment of squamous cell carcinoma is mainly surgical excision followed by radiation therapy and chemotherapy as additional postoperative treatment modalities.
Conclusion: Squamous cell carcinoma is the most common malignant neoplasm of the oral cavity with various oral presentations. Correct and timely diagnosis is of utmost importance and there is more possibility of misdiagnosis because the clinical presentation of oral squamous cell carcinoma can mimic gingival inflammatory lesions.
Keywords: Squamous cell carcinoma, mandibular, gingiva, oral
How to Cite
References
Irani S. Pre-cancerous lesions in the oral and maxillofacial region: A literature review with special focus on etiopathogenesis. Iran J Pathol. 2016;11(4):303-322.
PMID: 28855922; PMCID: PMC5563928
Cheung J, Al Afif A, Bullock MJ, Robertson C, Hart R, Goodday R. An unusual case of mandibular squamous cell carcinoma in intimacy with an impacted wisdom tooth. Case Rep Surg. 2019;2019:8360357. DOI: 10.1155/2019/8360357 PMID: 31110834; PMCID: PMC6487125
Abraham S, Mallika B, Reshma A, Kassim RM. An atypical case of oral squamous cell carcinoma of mandibular alveolus. Case Rep Dent. 2019;2019:2521685. DOI: 10.1155/2019/2521685
PMID: 31815021; PMCID: PMC6877988
Bharanidharan R, Dineshkumar T, Raghavendhar K, Kumar AR. Squamous cell carcinoma of the gingiva: A diagnostic enigma. J Oral Maxillofac Pathol. 2015;19(2):267. DOI: 10.4103/0973-029X.164558 PMID: 26604512; PMCID: PMC4611944
Palasz E, Wysocka A, Gasiorowska A, Chalimoniuk M, Niewiadomski W, Niewiadomska G. BDNF as a promising therapeutic agent in parkinson's disease. Int J Mol Sci. 2020;21(3):1170. DOI: 10.3390/ijms21031170. PMID: 32050617; PMCID: PMC7037114
Park HK, Kim TS, Geum DH, Yoon SY, Song JM, Hwang DS, et al. Mandibular intraosseous squamous cell carcinoma lesion associated with odontogenic keratocyst: A case report. J Korean Assoc Oral Maxillofac Surg. 2015;41(2):78-83. DOI: 10.5125/jkaoms.2015.41.2.78
Epub 2015 Apr 23 PMID: 25922819; PMCID: PMC4411732
Effiom OA, Adeyemo WL, Omitola OG, Ajayi OF, Emmanuel MM, Gbotolorun OM. Oral squamous cell carcinoma: A clinicopathologic review of 233 cases in Lagos, Nigeria. J Oral Maxillofac Surg. 2008;66(8):1595–9. DOI: 10.1016/j.joms.2007.12.025 PMID: 18634945
Ildstad ST, Bigelow ME, Remensnyder JP. Squamous cell carcinoma of the alveolar ridge and palate. A 15-year survey. Ann Surg. 1984;199(4):445-53. DOI: 10.1097/00000658-198404000-00012 PMID: 6712321; PMCID: PMC1353364.
Gupta R, Debnath N, Nayak PA, Khandelwal V. Gingival squamous cell carcinoma presenting as periodontal lesion in the mandibular posterior region. BMJ Case Rep. 2014;2014:1–4. DOI: 10.1136/bcr-2013-202511 PMID: 25139914; PMCID: PMC4139557
Alsharif MJ, Jiang WA, He S, Zhao Y, Shan Z, Chen X. Gingival squamous cell carcinoma in young patients: report of a case and review of the literature. Oral Surgery, Oral Med Oral Pathol Oral Radiol Endodontology. 2009;107(5):696–700. DOI: 10.1016/j.tripleo.2008.12.048. Epub 2009 Mar 9 PMID: 19272815
Verma PK, Srivastava R, Baranwal H, Chaturvedi T, Gautam A, Singh A. “Pyogenic granuloma - hyperplastic lesion of the gingiva: Case reports.” Open Dent J. 2012;6(1):153-6. DOI: 10.2174/1874210601206010153
Epub 2012 Oct 5 PMID: 23091574; PMCID: PMC3474946
Balaji SM. Oral squamous cell carcinoma: Advances in management. Indian J Dent Res. 2015;26(6):559. DOI: 10.4103/0970-9290.176889 PMID: 26888230