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- DOI 10.18231/j.jds.12383.1891550475
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CrossMark
Oral squamous cell carcinoma with extensive mandibular involvement: Unveiling the role of bone invasion patterns, tumor biology and molecular prognosticators with c-Myc and PanCK expression
- Author Details:
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Anshi Jain
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Shreya Chatterjee
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Devi Charan Shetty *
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Nikita Gulati
Anshi Jain
Background: Craniofacial and gnathic skeleton is primarily responsible for housing a myriad of benign and malignant neoplasms. Tumor biology and heterogeneity may have contributed to the lack of significant improvements in the clinical outcome of the disease despite advances in diagnosis and therapy. Although there is constant evolution of the TNM staging for oral squamous cell carcinoma, it does not encompass the complexities of the variation in bone invasion. Diving into the depths of the tumor microenvironment could significantly affect the prognosis and the treatment modality.
Case Report: A case of a 43-year-old male patient complained pain and swelling with pus discharge in left lower front and back tooth region for 6 months. Initial treatment was extraction of mandibular posterior teeth and diagnosing a hyperkeratotic patch in a private set up. On aggravation of symptoms, radiological investigation revealed extensive osteolytic, ill-defined radiolucent lesionextending from mesial of #43 region, crossing midline till the left molar and ramus region. Incisional biopsy demonstrated moderately differentiated OSCC. Histology of the resected specimen reconfirmed the squamous cell origin bone destruction. Assessment of the cervical lymph nodes revealed level IIa positive for tumor cell infiltration.
Discussion & Conclusion: Thorough assessment of the tumor microenvironment with a comprehensive set of immunomarkers and genomic analysis is vital to predict the biological behaviour of oral malignancies. Subsequently, there could be an alteration within the treatment modalities including surgical margins along with potential for targeted therapies.
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