EXTENSIVE MALIGNANT EPITHELIAL LESION IN PATIENT WITH CHRONIC RENAL DISEASE

Abstract

An 83-year-old light brown man was attended complaining of "pain on the right side of the mouth" for 1 year with difficulty feeding and chewing pain. Anamnesis revealed stage IV chronic renal disease, myocardial revascularization surgery, gastritis, depression, allergic rhinitis, recent weight loss, and previous smoking stopped 20 years ago. The extraoral examination showed facial asymmetry due to a swelling in the right mandibular body covered by normal skin. Intraoral examination evidenced an exophytic ulcer on the right edentulous mandibular alveolar ridge, extending from the parasymphysis to inferior retromolar region with verrucous aspect and irregular borders, hardened and painful to the palpation, and 7 × 3 cm in its largest diameter. Smear cytolopathology and incisional biopsy were performed. Diagnostic hypothesis was squamous cell carcinoma. The cytopathologic study revealed atypical cells strongly suggestive of malignant neoplasm. Histopathologic analysis confirmed the final diagnosis of moderately differentiated squamous cell carcinoma. The patient was referred for cancer treatment. An 83-year-old light brown man was attended complaining of "pain on the right side of the mouth" for 1 year with difficulty feeding and chewing pain. Anamnesis revealed stage IV chronic renal disease, myocardial revascularization surgery, gastritis, depression, allergic rhinitis, recent weight loss, and previous smoking stopped 20 years ago. The extraoral examination showed facial asymmetry due to a swelling in the right mandibular body covered by normal skin. Intraoral examination evidenced an exophytic ulcer on the right edentulous mandibular alveolar ridge, extending from the parasymphysis to inferior retromolar region with verrucous aspect and irregular borders, hardened and painful to the palpation, and 7 × 3 cm in its largest diameter. Smear cytolopathology and incisional biopsy were performed. Diagnostic hypothesis was squamous cell carcinoma. The cytopathologic study revealed atypical cells strongly suggestive of malignant neoplasm. Histopathologic analysis confirmed the final diagnosis of moderately differentiated squamous cell carcinoma. The patient was referred for cancer treatment.