Case presentation on Carcinoma of oral cavity.ppt

Oral cancer etiology diagnosis and treatment modalities

1. NADKARNI’S 21
ST
CENTURY HOSPITAL,
TUMOR BOARD
CASES PRESENTED BY
DR PRATIK AGRAWAL, FHNO FELLOW
MODERATOR: DR SANDEEP ISHI- MEDICAL ONCOLOGIST
DR SIDDHARTH NAGSHET- RADIATION ONCOLOGIST
CASES:
1.CARCINOMA OF TONGUE
2.CARCINOMA OF UNKNOWN PRIMARY
3.CARCINOMA OF BUCCAL MUCOSA

2. Case No.1: CARCINOMA OF TONGUE:
Clinical History: A 35 years old male
patient reported with ulcerative non healing
growth in right tongue from since 5-6
months
Biopsy: keratinizing, Squamous cell
carcinoma, grade II
Medical history: no any co morbidities
CECT : Ulcerative lesion in right lateral
border tongue,
extrinsic muscles-not involved
FOM & BOT- not involved
No significant lymph nodes
Dx: Carcinoma of right tongue
Clinical staging:
Planned: Surgical resection + plastic
reconstruction

3. Surgery: Right hemi glossectomy+
bilateral modified radical neck
dissection from level 1 to level 4+
plastic reconstruction by free radial
forearm flap
HPE:Keratinizing, squamous cell
carcinoma, grade II
pT:3cm, DOI: 1.3cm, WPOI- 5 is seen
PNI-present/ LVI- negative
Margins and base- free of tumour
pN- 2/31 nodes-positive
Pathological staging: TNM : pT3pN2b
Adjuvant treatment proposed by tumour
board: Adjuvant CT+RT

10. CASE NO 2.:CARCINOMA OF UNKNOWN PRIMARY
Clinical history: A 55 year old male patient
reported to the clinic with huge mass
in left cervical neck region from since
6-7 months
O/E: oral cavity-NAD/ Laryngoscopy- NAD
Medical history: no any co-morbidities
FNAC: Metastatic squamous cell
carcinoma
DX: Carcinoma of unknown primary
Planned: Surgical rection of left cervical
huge mass+ B/L MRND+ plastic
reconstruction by PMMC flap

11. Surgery: composite resection of left cervical
neck mass + left modified radical neck
dissection+ plastic reconstruction by PMMC
flap
HPE: Large metastatic poorly differentiated
carcinoma with sarcomatoid areas( probably
squmous).
size of tumor-14cm in argest dimension
extranodal extension present
pN- 1/5 positive nodes in left mrnd
- 1/16 positive nodes in right mrnd
Adjuvant treatment proposed by Tumor
board:
ADJ. CT RT

29. 3. CARCINOMA OF LEFT BUCCAL MUCOSA
Clinical history: A 62 years old
male patient reported with
ulcerative growth in left
buccal mucosa from since 8-
9months
medical history: HIV positive,
diabetic on medications
o/e: ulcerative growth of
approx4*5cm in size clinically
in left buccal mucosa, left
level Ib node palpable and
enlarged
bx: squmaous cell carcinoma
Dx: ca left buccal mucosa
plan: surgical resection+ mrnd+
plastic recostruction

30. Surgery: left composite
resection of buccal mucosa
growth+ mrnd+ extra oral
skin infiltration gropwth
excision+ bipaddle pmmc flap
HPE: keratinizing sq.cell
ca.grade II
maximal thickness-2.6 cm,DOI-
1cm,WPOI-3 is seen
PNI-present, LVI- present
pN-4/28- nodes-positive
pathological staging: pT2pN3b
adjuvant tx proposed by the
tumor board: ADJ.CT RT