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

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.