A 65-year-old female patient presented with painless swelling in left zygomatic region for one month. However, according to her history, this patient was once already treated for asimilar swelling in the same region six years ago..
H/o present illness: - She observed a swelling one month back and it was rapidly progressing in size and associated with intra-oral ulcers.
She was a known diabetic and smoker,and chewer for15years
Past History:- Similar complaints were observed six years back for which she underwent Hemi mandibulectomy and reconstruction along with adjuvant Radio Therapy at Vizag for a primary developed at gingivo-buccal sulcus.
Clinical Examination:- Firm, fixed, swelling left zygomatic region measuring 9x7x4 cm with left submandibular and cervical lymphadenitis.
Intra-oral Examination: Ulcero-proliferative growth measuring 4 to 6 cm in dimension.
-Ulcer was covered with necrotic slough, purulent discharge. Bleeding was observed at the lesion.
-Intra-oral extension was evident the inferior medical wall of left maxillary sims.
-CT- Scan showed a lesion extending into left maxillary sinus and hard palate with the destruction of posterolateral wall medical wall and four as left maxillary antum, inferiorly extending into oral cavity.
-Patient was subjected for FNAC which was positive for malignancy and planned for composite resection and reconstruction.
Patient was subjected for composite resection and reconstruction done. The specimen was sent for Histo-pathological examination and it was confirmed as “Squamous cell carcinoma” of maxillary sinus.
-Patient recovered well and discharged home. Normally she would have needed RT. Since margins and nodes where negative Patient was kept on surveillance.
