Management of a carcinoma in situ of the tongue margin, using a Nd:YAG laser, cross-linked hyaluronic acid (xHyA) gel and a porcine pericardium resorbable membrane: a case report.

Abstract

Background: Oral tongue squamous cell carcinoma is the most prevalent cancer of the oral cavity. To date, the mainstay management for carcinoma in situ of the oral cavity is the surgical radical removal of the neoplastic tis-sue. This paper describes a new approach in the management of an in situ carcinoma of the tongue margin, treated surgically by the use of Nd:YAG laser, the application of cross-liked hyaluronic acid (xHyA) gel and the placement of a resorbable porcine pericardium membrane (PPM).

Case presentation: The case involves a 49-years old male patient with no history of smoking and alcohol use, who presented a non-homogeneous leukoplakia of the right tongue border. The biopsy revealed high-grade lichenoid dysplasia, corresponding to severe epithelial dysplasia or carcinoma in situ (Tis), characterized by full-thickness dysplasia without stromal invasion.

Conclusions: The case shows that the combined use of Neodimium laser surgery, xHyA gel and PPM is a viable option for promoting soft tissue regeneration in the oral cavity, enabling excellent clinical results in terms of healing medium-sized surgical defects. In addition, compared with other options for the reconstruction of surgical defects of the tongue, the clinical use of the association between these two materials has several biological advantages due to the absence of donor sites and high patient tolerability.