J Korean Assoc Oral Maxillofac Surg.  2015 Apr;41(2):78-83. 10.5125/jkaoms.2015.41.2.78.

Mandibular intraosseous squamous cell carcinoma lesion associated with odontogenic keratocyst: a case report

• Park HK
• Kim TS
• Geum DH
• Yoon SY
• Song JM
• Hwang DS
• Cho YC
• Kim UK

• KMID: 2189467
• DOI: http://doi.org/10.5125/jkaoms.2015.41.2.78

Abstract

Squamous cell carcinoma (SCC) is the most common malignant tumor in the oral cavity, and it accounts for about 90% of all oral cancers. Several risk factors for oral SCC have been identified; however, SCC associated with odontogenic keratocysts have rarely been reported. The present study describes the case of a 36-year-old man with SCC of the right ramus of the mandible, which was initially diagnosed as a benign odontogenic cyst. He underwent enucleation at another hospital followed by segmental mandibulectomy and fibular free flap reconstruction at our institution. In this case, we introduce a patient with oral cancer associated with odontogenic cyst on the mandible and report a satisfactory outcome with wide resection and immediate free flap reconstruction.

Keyword

Odontogenic cyst; Squamous cell carcinoma; Anatomic models; Free tissue flaps

MeSH Terms

Adult
Carcinoma, Squamous Cell*
Free Tissue Flaps
Humans
Mandible
Mandibular Osteotomy
Models, Anatomic
Mouth
Mouth Neoplasms
Odontogenic Cysts*
Risk Factors

Figure

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  Fig. 1 Clinical intraoral finding.

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  Fig. 2 Preoperative radiographic imaging. A. Computed tomography imaging (the line indicates squamous cell carcinoma lesion with cyst on mandibular right posterior site). B, C. Magnetic resonance imaging.

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  Fig. 3 Intra-operative reconstructive plating before segmental mandibulectomy.

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  Fig. 4 Final soft tissue specimen showing squamous cell carcinoma (SCC) lesion with cyst. A. Cyst site (H&E staining, ×20). B. SCC site (H&E staining, ×20) adjacent to the cyst. C. SCC site (H&E staining, ×100). D. SCC site (H&E staining, ×200).

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  Fig. 5 Postoperative specimen showing squamous cell carcinoma (SCC) bone lesions. A. SCC bone invasion site (H&E staining, ×40). B. SCC bone lesion (H&E staining, ×100). C. SCC bone lesion (H&E staining, ×200). D. SCC bone lesion (H&E staining, ×400).

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  Fig. 6 Rapid prototype (RP) model. RP model of mandible (a), required bone graft design with resin block (b), RP model-fibular resin model (c).

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  Fig. 7 Pre- and postoperative panoramic views. A. Preoperative state. B. Postoperative three month. C. Postoperative one year.

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  Fig. 8 Postoperative face change. A. Preoperative state. B. Three month later. C. One year later.

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