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A
10-year-old boy presented with a 4-week history of a rapidly increasing
bleeding tumor in the oral cavity. There was weight loss of 5 kg in the
past four weeks. Physical examination revealed a huge ulcerating 33 cm
measuring tumor mass in the floor of the mouth, well circumscribed,
fleshly, and glistening with a pale-gray surface. The lesion displaced
the lower incisors indicating mandibular bone infiltration. In
addition, enlargement of submandibular lymph nodes was noted, ranging
in
dimension from 2 to 2.5 cm in diameter. Chemotherapy was effective in
reducing tumor mass, followed by partial anterior mandibulectomy and
reconstruction with composite microvascular tissue transfer. The
approach allowed radical resection of the tumor and functional
reconstruction with excellent aesthetic results. 6 years after therapy
the boy is well without evidence of disease.
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