Open Access
Table 1
Summary of all the five cases.
| Features | Case 1 | Case 2 | Case 3 | Case 4 | Case 5 |
|---|---|---|---|---|---|
| Age | 60 | 62 | 46 | 71 | 72 |
| Sex | Male | Male | Male | Female | Female |
| Local examination | Ulceroproliferative growth was noted in the left buccal mucosa reaching the left lower gingivobuccal sulcus and retromolar trigone measuring 2.5 × 2.5 cm | Ulcerative growth in the right buccal mucosa upto retromolar trigone. | Ulceroproliferative growth in left buccal mucosa and lower gingivobuccal sulcus | Ulceroproliferative growth in right buccal mucosa | Ulcerated lesion noted over right LGBS and alveolus. |
| CT findings | Lesion in the left buccal mucosa measuring 12.4 mm with no bony erosions | Enhancing thickening 31 × 22 × 9 mm in buccal mucosa, reaching up to retromolar trigone with superficial erosion of right mandible. | Tumour measuring 2.3 × 2.2 cm lesion involving the left LGBS with RMT involvement and erosion of left hemimandible. | 3.2 × 2 cm lesion involving the right buccal mucosa extending to upper GBS and erosion of right upper alveolus. | 3.6 × 2.5 cm lesion involving right lower GBS and alveolus with right mandibular bony involvement. |
| Punch biopsy | Well-differentiated squamous cell carcinoma | Well differentiated squamous cell carcinoma | Well-differentiated squamous cell carcinoma | Moderately differentiated squamous cell carcinoma | Moderately differentiated squamous cell carcinoma |
| cTNM | cT2N0 | cT4aN0 | cT2N0 | cT4aN0 | cT4aN0 |
| Management of the primary lesion- Upfront surgery with lymphadenetomy for all the cases | Left marginal mandibulectomy with left selective neck dissection (I- III) and submental flap repair | Wide Local excision + Segmental Mandibulectomy and MRND type II and PMMC flap repair | Wide local excision with segmental mandibulectomy with Selective neck dissection (I- III) With primary repair. | Infrastructure maxillectomy with extended Supraomohyoid neck dissection (I- IV) with obturator placement | Wide Local Excision + Rt Segmental Mandibulectomy +Rt upper Alveolectomy with selective neck dissection (I-III). |
| Final HPE | Carcinoma cuniculatum | Carcinoma cuniculatum | Carcinoma cuniculatum | Carcinoma cuniculatum | Carcinoma cuniculatum |
| Tumour size | 3 × 2 × 0.8 cm | 3.1 × 2.2 × 0.9 cm | 3 × 2 × 1.5 cm | 4 × 2 × 1 cm | 3 × 3 × 1.8 cm |
| Site | Buccal mucosa | Buccal mucosa | Buccal mucosa | Upper gingivobuccal sulcus, alveolus | RMT, Lower and upper GBS, upper alveolus |
| DOI | 0.7 | 1.7 | 1.1 | 0.5 | 1.2 |
| LVI/PNI | –/– | –/– | –/– | –/– | –/– |
| WPOI | 4 | 4 | 3 | 3 | 4 |
| Margins | Negative | Negative | Negative | Negative | Negative |
| Underlying bone | Uninvolved | Involved | Uninvolved | Involved | Involved |
| Neck lymph nodes | 0/31 | 0/17 | 0/19 | 0/33 | 0/25 |
| pTNM | pT2N0 | pT4aN0 | pT3N0 | pT4aN0 | pT4aN0 |
| Head and neck DMG* decision | Observation | Adjuvant RT | Observation | Adjuvant RT | Adjuvant RT |
| Follow-up (12–18 months) | Doing well No recurrence | Doing well No recurrence | Doing well No recurrence | Patient developed local recurrence. Started on oral metronomic therapy | Doing well No recurrence |
*DMG – Disease management group.
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