A case of squamous cell carcinoma of the lower gingiva.

A 58-year-old man complaining of a bloating sensation of the jaw was referred to our division. Physical examination revealed a huge tumor in the lower jaw protruding to the neck, and subsequent skin ulceration. Magnetic resonance imaging demonstrated a tumor occupying the floor of the mouth, 96 92 95 mm in size, which extended from the left mandibular joint to the left side of the hyoid bone and larynx (Fig. 1). Biopsy of the tumor revealed squamous cell carcinoma. The patient underwent total grosso-laryngectomy and subtotal mandibulectomy combined with extensive dissection of the bilateral neck lymph nodes. Free rectus abdominis myocutaneous flap was transplanted to compensate the oropharyngeal tissue defect, and free fibulaosteocutaneous flap was utilized to cover the bone and skin defect. Pathologically, the tumor was diagnosed as well-differentiated squamous cell carcinoma arising from the lower gingiva involving the skin and the bone marrow of the mandible (Fig. 2). A few regional nodal metastases were found, but surgical margins were negative for cancer. The patient is doing well without any sign of recurrence 4 months after the operation.