Soo Joanne, Kokosis George, Ogilvie Michael, Sara Jiang Xiaoyin, Powers David B, Rocke Daniel J, Erdmann Detlev
Duke University School of Medicine, Duke University Medical Center, Durham, N.C.; Division of Plastic, Maxillofacial, and Oral Surgery, Duke University Medical Center, Durham, N.C.; Department of Pathology, Duke University Medical Center, Durham, N.C.; and Division of Otolaryngology - Head and Neck Surgery, Duke University Medical Center, Durham, N.C.
Plast Reconstr Surg Glob Open. 2016 Dec 23;4(12):e1070. doi: 10.1097/GOX.0000000000001070. eCollection 2016 Dec.
Oral lichen planus (OLP) is an immune-mediated mucocutaneous disease associated with an increased risk in oral squamous cell carcinoma (OSCC). Nearly all cases of malignant transformation have been reported in patients >40 years old. We report the case of a 37-year-old woman with a 5-year history of erosive OLP who presented with malignant transformation to OSCC. Delineating the margins of the disease was impossible at presentation given her OLP, and she was initially treated with concurrent chemoradiation therapy. She then developed a recurrence of the mandibular alveolar ridge. The patient was successfully treated with a composite resection including a segmental mandibulectomy, buccal mucosa resection, partial glossectomy, and ipsilateral neck dissection. This was reconstructed with a free fibula osteo-septo-cutaneous flap. Mandibular OSCC is a rare complication of OLP with few reports on effective reconstructive interventions. The case represents the youngest reported patient with mandibular OSCC arising in the context of OLP and highlights the utility of the free vascularized fibula graft in the treatment of these patients.
口腔扁平苔藓（OLP）是一种免疫介导的黏膜皮肤疾病，与口腔鳞状细胞癌（OSCC）风险增加相关。几乎所有恶性转化病例均报道于40岁以上患者。我们报告一例37岁女性，有5年糜烂性OLP病史，出现了向OSCC的恶性转化。由于其OLP，在就诊时无法确定病变边界，她最初接受了同步放化疗。随后她下颌牙槽嵴复发。患者成功接受了包括节段性下颌骨切除术、颊黏膜切除术、部分舌切除术和同侧颈部清扫术在内的联合切除术。用游离腓骨骨-皮-肌瓣进行了重建。下颌骨OSCC是OLP的一种罕见并发症，关于有效重建干预的报道很少。该病例是报道中最年轻的在OLP背景下发生下颌骨OSCC的患者，并突出了游离带血管腓骨移植在治疗这些患者中的作用。
