A case of adenosquamous carcinoma of the mandibular gingiva

Abstract

Adenosquamous carcinoma (ASC) is a rare malignant tumor in the oral and maxillofacial region. We report a case of ASC that arose in the mandibular gingiva. A 74-year-old man visited our hospital with the complaint of pain of the left submandibular gingiva and eating disorder in early January 2009. On the initial examination, there was an elastic soft, dark violet, and hemorrhagic mass of 55×25 mm in diameter in the left mandibular gingiva. He had hypoesthesia in his left mentum. The mass reached the mandibular canal on CT examinations, and two submandibular lymph nodes were suspected of metastasis on ultrasound examinations. A biopsy specimen showed components of squamous cell carcinoma and mucin-producing adenocarcinoma with positive reaction to diastase-digested periodic acid Schiff stain. We thus diagnosed this as ASC (T4N2bM0). As his condition of interstitial pneumonia was severe and he did not wish to receive surgical operation, he underwent radical chemoradiation therapy (oral administration of UFT and external radiation). After the therapy, some metastatic nodules were newly seen in areas of the lung, skin of the abdomen, and axillary skin. At the end of April, he died of breathing difficulties.