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- Title
Oral Squamous Cell Carsinoma Due to a Long-Term Smoking Habit: The Case Study.
- Authors
Kende, Silfra Yunus; Hendarti, Hening Tuti; Ernawati, Diah Savitri
- Abstract
Oral Squamous Cell Carcinoma (OSCC) is a common form of oral cancer with a multifactorial etiology, mainly associated with smoking, alcohol and individuals' genetic risk of developing oncogenes. OSCC cannot be diagnosed clinically but only by means of cytology and histopathology (HPA). Case Presentation: A 22 year-old male attended Universitas Airlangga Hospital Dental Clinic complaining primarily of an oral ulcer on the right-hand edge of the tongue which had been growing increasingly painful since the previous week. The ulcer in question had appeared six months before, causing the patient to seek medical attention at a health centre. Despite a combination of triamcinolone acetonide and diclofenac sodium having been prescribed, the oral ulcer failed to heal. The patient acknowledged having smoked an average of 12 cigarettes a day for approximately two years before developing the condition. Extra-oral examination confirmed the right-hand lymph nodes to be palpable, supple, and painful. Intra-oral examination revealed a major ulcer 2.5 cms in length with a necrotic base, erythema and an elevated, indurated lesion. The patient appeared to present a squamous cell carcinoma on the lateral dextra of the tongue with a differential diagnosis of chronic aphthous stomatitis. Case management: The panoramic radiographic examination which the patient underwent confirmed no invasive presentation in the mandible bone. FNAB cytologic and direct mycologic examinations were performed revealing dysplasia cell and fungal hyphae. The patient was diagnosed with Stage III OSCC, T3N1M0 (invasive tumor, metastase in unilateral lymph nodes) and oral candidiasis before being referred to an oncology surgeon. The patient was prescribed Benzydamine HCL 0.15% as an anesthetic, analgesic oral rinse and an immune modulator drug. Moreover, he was instructed to stop smoking, use a prescribed mouthwash regularly, and increase his general oral hygiene. The final treatments administered were a hemiglossectomy and lymphadenectomy followed by a course of radiotherapy. A long-term smoking habit represents a carcinogen initiator risk factor for gene mutation and oncogenic gene activation with delayed diagnosis and/or treatment serving to exacerbate the condition.
- Subjects
SQUAMOUS cell carcinoma; HEALTH; SMOKING; TRIAMCINOLONE acetonide; DICLOFENAC
- Publication
Journal of International Dental & Medical Research, 2018, Vol 11, Issue 1, p334
- ISSN
1309-100X
- Publication type
Case Study