The consequences of late diagnosis and the importance of complementary examinations in oral squamous cell carcinoma

Abstract

A 73-year-old female sought dental treatment for an erythematous ulcer in her alveolar mucosa, initially thought to be an odontogenic infection. After extracting teeth 17 and 18 with no improvement, Pemphigus Vulgaris was diagnosed and treated for 2 years with laser therapy and oral corticosteroids. Multiple erythematous ulcers with irregular nodular margins were present across the right hemiarch, in the vestibulo-palatal alveolar mucosa area, and in the anterior portion of the right hard palate. Another specialist performed an incisional biopsy, revealing aggressive Squamous Cell Carcinoma, staged as pT3 pN3b. The patient underwent partial maxillectomy, neck dissection, and radiotherapy. To reduce radiotherapy-induced oral symptoms, pre- and postneoplastic therapy evaluations were conducted. The importance of an early biopsy to avoid delayed diagnoses and mutilating therapies is highlighted, as is the need for active surveillance and complementary tests for a precise and swift diagnosis.