MULTIDISCIPLINARY MANAGEMENT OF DIFFUSE LARGE B-CELL LYMPHOMA OF THE MANDIBLE

Abstract

We present a case of a 25-year-old Hispanic female with a diffuse large B-cell lymphoma of the mandible. The case documents the patient's complete cancer treatment and the role of the dental team as part of a larger oncology team to help prevent and manage oral complications. The dental team collaborated with the medical and radiation oncology teams to screen, diagnose, stage, treat, and manage the patient. Prior to cancer treatment, the dental team completed an oral health examination and established a schedule of dental treatment. Treatment consisted of patient education, oral hygiene instruction, dental prophylaxis, elimination of acute oral infections, fabrication of custom gel-applicator trays, fluoride gel prescription, and fabrication of a customized tongue-displacing (CTD) stent with a novel design. We believe it is the first reported use of a CTD for a gnathic non-Hodgkin lymphoma. During and after cancer treatment, the dental team managed complications of chemotherapy and radiation therapy including dysgeusia, xerostomia, oral mucositis, and trismus. No recurrence has been recorded after eighteen months. Dentists play an important role in managing and preventing oral complications of cancer treatment.