| Popis: |
Malignant tumors of the salivary glands can occur in any place where the tissue of the salivary glands is located, such as the lips, oral cavity, pharynx, nose, paranasal sinuses. The oral cavity can be the location of metastatic lesions of malignant primary tumors located elsewhere. The organs from which these tumors can metastasize to the jaw are breast, lung, kidney, and thyroid. Adenocarcinomas of the mandible appear extremely rarely as primary tumors in the oral cavity. A 44- year-old patient was reffered to the Department of Oral Surgery of the University Dental Clinic Zagreb, due to pain in the lower jaw. The anamnestic status was normal, the patient was a non-smoker and denies any other chronic diseases. A clinical and radiological examination revealed an impacted wisdom tooth with a cystic formation in the area of the right angle of the mandible, alveotomy and PHD analysis were performed. Histological findings showed an adenomatoid odontogenic tumor. During the second surgical procedure, the tumor formation was extirpated under general anesthesia. A repeated histological finding showed a well-differentiated adenocarcinoma, partly of a pronounced papillary morphology, and partly of the salivary gland type. Lung, thyroid gland and breast were safely excluded as primary sites, and the conclusion was that it was a primary adenocarcinoma of the mandible. The patient underwent surgery and a segmental resection of the right mandible and reconstruction of the defect with a free microvascular flap of the fibula was performed. A free skin graft was also taken from the upper leg to cover the skin defect. Diagnosing adenocarcinoma of the mandible is a complex and challenging procedure, based mostly on histopathology. Treatment and monitoring of such conditions requires a multidisciplinary approach of specialists from different branches of medicine and dentistry |
