ORAL LEUKOPLAKIA, THE FIRST CLINICAL FINDING OF ORAL SQUAMOUS CELL CARCINOMA (OSCC): A CASE REPORT

Embun Manja Sari, Fika Faradilla Drakel, Riani Setiadhi
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Abstract

Background: Oral squamous cell carcinoma (OSCC) is preceded by oral potentially malignant disorders (OPMD). Oral leukoplakia (OL) is a non-scrapable white plaque lesion on oral mucosa and one of OPMD. Lack of knowledge about signs and symptoms of OPMD and health care providers are responsible for delays in establishing the diagnosis. Objectives: to improve health care provider’s knowledge and the importance of detecting leukoplakia as an early sign of malignancy. Case: A 30-year-old woman came to the oral disease clinic at Hasan Sadikin Hospital complaining of canker sores and a lump on right tongue that had not been healed since 3 months ago. She had history of chronic irritation on tongue which was bitten by linguoversion tooth 46. Intraorally there was a solid mass, irregular edge in lateral right tongueat region tooth 46, 1.5 x 0.5 cm in size and a white plaque at region 46-48, 11 x 10 mm in size, could not be scrapped, unpainful on touched but felt sore when eating and drinking. Based on anamnesis, extraoral and intraoral examination, the working diagnosis was suspected fibroma region 46 and OL region 46-48. Case management: Pharmacological manage,ment was povidone-iodine mouthwash and referred to Oral Surgery Department. Well-differentiated OSCC was made as definitive diagnosis, based on histopathological examination and CT-Scan which showed bilateral lymph nodes enlargement. The patient was referred to Haemato-oncology Department for chemotherapy. Conclusion: it is important to do histopathological examination and CT-Scan as an effort for establishing OL as the early sign of malignancy. Keywords :          Oral cancer, Oral leukoplakia, Oral potentially malignant disorders 
口腔白斑,口腔鳞状细胞癌(oscc)的第一个临床表现:1例报告
背景:口腔鳞状细胞癌(OSCC)发生于口腔潜在恶性疾病(OPMD)。口腔白斑是口腔黏膜上的一种不可刮擦性的白色斑块病变,是OPMD的一种。缺乏对OPMD体征和症状的了解以及卫生保健提供者对确定诊断的延误负有责任。目的:提高卫生保健提供者的知识和检测白斑作为恶性肿瘤早期征象的重要性。病例:一名30岁妇女到Hasan Sadikin医院口腔疾病门诊就诊,主诉3个月前右舌溃疡和肿块未愈合。她有舌头慢性刺激史,曾被舌翻牙咬伤。口腔内右舌侧区第46号牙1.5 × 0.5 cm,边缘不规则实性肿块,第46 ~ 48号牙11 × 10 mm,白色斑块,不能刮掉,触摸无痛,但进食和饮水时感到疼痛。基于记忆、口外及口内检查,工作诊断为疑似纤维瘤46区及OL 46-48区。病例处理:药理学处理,使用聚维酮碘漱口水治疗,转诊口腔外科。组织病理学检查和ct扫描显示双侧淋巴结肿大,明确诊断为高分化OSCC。患者转诊至血液肿瘤科接受化疗。结论:组织病理学检查和ct扫描是确定OL为恶性肿瘤早期征象的重要手段。关键词:口腔癌,口腔白斑,口腔潜在恶性疾病
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