Adeel Maira, Andaleeb Hira, Shakil Saad, Akhtar Sareema Eman, Almas Talal, AlSubai Abdulla K, AlNajdi Sara, Alenizi Aryam Mohammed, Aldhaheri Khaled Saeed Obaid, Aqil Shakil
Department of Otorhinolaryngology - Head and Neck Surgery, Liaquat National Hospital and Medical College, Pakistan.
Ziauddin Medical College, Karachi, Pakistan.
Ann Med Surg (Lond). 2022 Sep 8;82:104573. doi: 10.1016/j.amsu.2022.104573. eCollection 2022 Oct.
and Importance: Oral Squamous Cell Carcinoma (OSSC) is one of the most common malignancies of the oral cavity and is one of the ten most prevalent tumours in the world. Control of this tumor is difficult and challenging as its propensity to spread is embedded in the cancer field of epithelial cells which alter these cells and induce a malignant potential within them. Simultaneous bilateral primary tumours are a rare presentation in the oral cavity which highlights the significance of early diagnosis and treatment.
Here we present a case of 50-year-old gentleman known case of diabetes, hypertension and chronic history of beetle nut chewing who developed a simultaneously growing bilateral primary OSSC in the buccal mucosa. CT scan revealed a heterogeneous enhancing thickening in the bilateral buccogingival mucosa. A wide local excision of bilateral buccal mucosa with bilateral marginal mandibulectomy with neck dissection was planned.
The majority of the case report emphasises the relevance of simultaneously developing bilateral primary oral cavity tumours in a patient who had a history of consuming beetle nuts. The independent incidence of bilateral primary OSSC in individuals without a history of tobacco, beetle nut, or alcohol use has also been documented in a small body of research. Due to the considerable clinical variety in its presentation, it is necessary to include bilateral primary OSSC when making a differential diagnosis of OSSC.
Multiple bilateral primary tumours of the oral cavity are typically on the rise. The prognosis and survival of these individuals are considerably improved by close surveillance and early, expectant management of these cancers. This case study emphasises the value of thorough screening techniques used at an early stage to find these lesions and treat them appropriately.
及其重要性：口腔鳞状细胞癌（OSSC）是口腔最常见的恶性肿瘤之一，也是全球十大最常见肿瘤之一。由于其扩散倾向存在于上皮细胞癌灶中，会改变这些细胞并诱导其产生恶性潜能，因此控制这种肿瘤既困难又具有挑战性。同时发生的双侧原发性肿瘤在口腔中较为罕见，这凸显了早期诊断和治疗的重要性。
在此，我们报告一例50岁男性患者，他患有糖尿病、高血压，并有长期嚼槟榔史，在颊黏膜处同时出现双侧原发性OSSC。CT扫描显示双侧颊龈黏膜有不均匀强化增厚。计划对双侧颊黏膜进行广泛局部切除，并进行双侧下颌骨边缘切除术及颈部清扫术。
大多数病例报告强调了在有嚼槟榔史的患者中同时发生双侧原发性口腔肿瘤的相关性。一小部分研究也记录了在无烟草、槟榔或酒精使用史的个体中双侧原发性OSSC的独立发病率。由于其临床表现差异很大，在对OSSC进行鉴别诊断时，有必要考虑双侧原发性OSSC。
口腔多发双侧原发性肿瘤通常呈上升趋势。通过对这些癌症进行密切监测和早期、积极的治疗，这些患者的预后和生存率可得到显著改善。本病例研究强调了早期使用全面筛查技术发现这些病变并进行适当治疗的价值。
