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147:Orofacial and Throat Pain as the First Sign of Oral Squamous Cell Carcinoma[AAOM2020]
EP36054
Poster Title: 147:Orofacial and Throat Pain as the First Sign of Oral Squamous Cell Carcinoma[AAOM2020]
Submitted on 29 Mar 2021
Author(s): Ahammad Kandari, Ivonne Hernandez, Reid Friesen
Affiliations: University of Alberta, Canada
This poster was presented at 2021 American Academy of Oral Medicine Virtual Conference
Poster Views: 337
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Poster Information
Abstract: Background: Oral squamous cell carcinoma (OSCC) has varying clinical presentations. Rarely, it may masquerade as other, more commonly seen conditions; such as jaw pain or a toothache. 37% of patients with OSCC first present with throat pain. A proper history and clinical examination along with a proactive multidisciplinary approach is the best method for early detection.

Case Summary: A 55-year-old female patient presented to an oral medicine (OM) clinic for assessment of left-sided facial pain. She reported pain in the left cervical, preauricular areas, and ear. She also previously reported pain in her lower molars. She had been seen by a physician, otolaryngologist, and dentist before seeing the OM clinic. The initial symptom was throat pain, with ENT examination showing no abnormalities. Subsequently, the pain manifested in her left molars which led to tooth extraction. No radiographical changes

At the oral medicine appointment, examination revealed no pathology to account for her pain. There was moderate masticatory myalgia, with a left masseter trigger point. Medical history was unremarkable. She reported occasional alcohol consumption and smoking 5 cigarettes per day. A diagnosis of myofascial pain was given. Physiotherapy and splint therapy treatment was completed and were effective to palliate her pain. She returned a month later indicating, she could not eat due to tongue pain. The patient reported she had injured the left side of her tongue one year ago while cleaning her teeth, leading to one month of pain before resolving. However, the pain recurred. A subsequent examination was performed, and an indurated lesion was felt posterior to the foliate papilla. Ensuring evaluation and biopsy leads to a diagnosis of OSCC with metastasis to the neck and base of the tongue. After the fact, the patient admitted underreporting her alcohol and tobacco intake.

Conclusions: OSCC does not always initially present as a pathologic lesion affecting the oral mucosa. This case shows that orofacial pain can be the first presentation of OSCC. OSCC must be included in the differential for facial and throat pain. A team effort is required to rule out odontogenic and non-odontogenic sources of pain.
Summary: Oral squamous cell carcinoma ( has varying clinical presentations Rarely, it may masquerade as other, more commonly seen conditions such as jaw pain or a toothache 37 of patients with OSCC first present with throat pain A proper history and clinical examination along with a proactive multidisciplinary approach is the best method for early detection.

Ask the author questions about this poster:ahmed_alkanderi@outlook.com
References: https://linkinghub.elsevier.com/retrieve/pii/S1079210404000605

https://www.scirp.org/pdf/OJST20110300004_28772522.pdf

https://www.oooojournal.net/article/S1079-2104(05)00916-9/fulltext
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