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Revista Española de Cirugía Oral y Maxilofacial

On-line version ISSN 2173-9161Print version ISSN 1130-0558

Abstract

STAVARU MARINESCU, Bogdan; NAVAL GIAS, Luís  and  RODRIGUEZ CAMPO, Francisco José. Aggressive tumor growth associated with the use of mandibular distraction osteogenesis: a case presentation. Rev Esp Cirug Oral y Maxilofac [online]. 2016, vol.38, n.3, pp.121-127. ISSN 2173-9161.  http://dx.doi.org/10.1016/j.maxilo.2014.02.005.

Purpose: to report an unusual case of aggressive tumoral growth related to the use of mandibular distraction. The clinical situation presented suggests that the biochemical factors released during the osseous distraction can interfere with the development of the active malignant tumors, triggering a rapid progression. Material and methods: We present the case of a patient who had a history of recurrent sclerosing basal cell carcinoma in the left chin area. Despite of the multiples attempts to completely remove the tumor and the close follow- up conducted, 18 years from the initial diagnosis the biopsies taken showed tumoral infiltration of the mandibular bone. In order to take advantage of the slow rate of the tumoral growth, we decided to carry out a bilateral mandibular distraction before performing the mandibular resection and reduce in this manner the amount of the bone necessary for the reconstruction. Five weeks after the onset of the bone distraction a newly emerging tumoral mass could be observed in the anterior floor of the mouth, which was confirmed to have the same histological diagnose as the initial tumor. Results: Due to the unexpected complication we had to abandon the distraction and decided to perform a full-thickness resection of the inferior third of the face and the reconstruction of the defect using a free vascularized fibular graft and a pectoralis major myocutaneous flap. Conclusion: Distraction osteogenesis can complicate the course of a local neoplastic process and its use should be valued as a potential contraindication in patients with active tumors.

Keywords : Tumoral growth; Mandibular distraction; Sclerosing basal cell carcinoma.

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