engleski

Incorrect or delayed diagnosis - case report

Introduction: Tumors of the oral cavity are the 6th most common tumors in humans, including 2%-6% of all tumors and 30% of tumors of head and neck. The male population in underdeveloped countries is more often affected with a ratio of women to men of 1:9. In developed countries the ratio is 1:1.5. The world annual incidence is 4:100, 000, with average mortality rate 1.9:100, 000. Proven hereditary predisposition, the consumption of strong alcohol and tobacco is associated with the development of cancer of the oral cavity and oropharynx. More than 300 carcinogens in cigarette smoke lead to malignant transformation of epithelial cells. The synergistic effect of alcohol and tobacco increases the risk to over 38%. More than 90% of all oral cavity tumors are squamous cell carcinomas. Case report: A 56-year- old patient comes to the Department of Oral Surgery. He was previously treated 3 times due to exophytic formation in regio 13 in another institution by a periodontologist for past 7 months without success. The patient presents with swelling and occasional pain that has intensified over the past month. Clinical and radiological work-up and biopsy resulted in a PHD finding of squamous cell carcinoma of the gingiva. The patient underwent segmental resection of the maxilla, with selective neck dissection and reconstruction with a free fibula flap and adjuvant radiotherapy (66 Gy/30x). Postoperative recovery went smoothly, and 2 years follow-up is without signs of recurrence or deterioration of carcinoma. This case aims to show the importance of good diagnostics and the consequences that arise if mistakes are made. It should be emphasized that every clinician will make a mistake in their work at least once, luckily with consequences. Most clinicians are not aware of the mistake they have made due to a number of reasons, so the feedback on diagnostic performance is extremely important.

squamous cell carcinoma ; gingiva ; maxilla ; radiotherapy

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