Abstract
Malignant oral neoplasms have great relevance because they represent one of the main causes of death in the world. Squamous cell carcinoma is its most frequent form, but reports in the retromolar region are rare when compared to other oral sites. The objective of this work is to demonstrate the diagnosis and conduct in the case of a patient participating in the Oral Injury extension project (LeBu) at the State University of Maringá - PR/BR. Male patient, 67 years old, a heavy smoker for about 50 years, alcoholic, attended the university with an ulcer in the right lower retromolar region of brownish-white color, with approximately 3 to 4 mm, irregular shape, and rough surface. A biopsy was performed in the lesion region, collecting a fragment of approximately 2 mm, which was referred for histopathological examination, resulting in a diagnosis of moderately differentiated, invasive squamous cell carcinoma. The patient was referred for medical oncological, surgical, and chemotherapy treatment, remaining under dental monitoring throughout the treatment and later with scheduled returns. After 4 years of follow-up, the patient is in good general physical condition, with no signs of recurrence, orally rehabilitated, even quitting the smoking habit. Thus, it is concluded that the diagnosis and treatment of head and neck neoplasms lacks a multidisciplinary view, being the dental surgeon of great importance both for the diagnosis of these injuries, as well as in the prevention and treatment of injuries that may arise from or after the treatment.
Highlights
Malignant neoplasms of the oral cavity represent a relevant oral health problem, mainly due to their high occurrence (Brener, Jeunon, Barbosa & Grandinetti, 2006)
According to data from the National Cancer Institute (INCA) of the Ministry of Health in 2020, cancers present in the oral cavity occupy the 5th place in greatest occurrences in men in Brazil, and among these cases, squamous cell carcinoma occupies almost 90%, being considered the most common oral malignancy (National Cancer Institute, 2020 and Brener et al, 2006)
Cancer in this region is relatively rare, representing about 7% of the cases of squamous cell carcinoma in the oral cavity (Andrade, Santos, & Oliveira, 2015). When present in this region, malignant neoplasms often result in bone infiltration, lymph node metastasis and infiltration into the infratemporal fossa in the initial stage, which reflects a worse prognosis when compared to the same type of cancer in neighboring areas, such as the floor of the mouth, gums and tonsils, especially as they are often diagnosed at a late stage due to the absence of early symptoms (Nishi, Shinozaki, Tomioka, Maruo, & Hayashi, 2018 and Faisal et al, 2017)
Summary
Malignant neoplasms of the oral cavity represent a relevant oral health problem, mainly due to their high occurrence (Brener, Jeunon, Barbosa & Grandinetti, 2006). Mouth and oropharynx cancer affects, in greater prevalence, men over 50 years of age and is closely related to smoking and alcohol consumption, especially when associated This is further aggravated by the common delay in diagnosis, mainly due to the lack of information on the part of the population and health professionals, which can reflect on a poor prognosis (Brener et al, 2006). The retromolar region is covered by soft tissue, located immediately posterior to the last lower molars and classified as oral mucosa taking into account its anatomical position Cancer in this region is relatively rare, representing about 7% of the cases of squamous cell carcinoma in the oral cavity (Andrade, Santos, & Oliveira, 2015).
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