A 55 year old male patient complains of abnormal growth on right cheek. Patient has a habit of tobacco chewing since 30 years. Radiologic findings reveal 8×8 cm fungating mass, invading maxilla and mandible on right side. Histologic findings are suggestive of squamous cell carcinoma. Which of the following is not true regarding the treatment of this condition?
**Core Concept:** Squamous cell carcinoma (SCC) is a type of cancer that originates from squamous cells, which are flat or cuboidal cells that line the respiratory and gastrointestinal tracts, as well as the skin. Tobacco use is a major risk factor for developing SCC, particularly in the head and neck region. Radiologic findings may include a fungating mass invading nearby structures, such as the maxilla and mandible. Histologic examination confirms the diagnosis.
**Why the Correct Answer is Right:**
In this case, the correct answer is **Option A (A):**
The patient has a fungating mass (a prominent, protruding mass) and has been chewing tobacco for 30 years. Squamous cell carcinoma typically presents as a rapidly growing, ulcerated mass (not a fungating mass). Additionally, SCC typically presents with a history of tobacco and/or alcohol consumption, not tobacco chewing alone.
**Why Each Wrong Option is Incorrect:**
**Option B:** Squamous cell carcinoma is not typically caused by alcohol consumption alone, as tobacco use is a more significant risk factor.
**Option C:** Although radiographic findings like fungating mass invading maxilla and mandible are common in SCC, the absence of these findings does not rule out SCC.
**Option D:** The presence of a fungating mass invading maxilla and mandible is consistent with SCC, but the patient's age (55 years) is not explicitly mentioned as a factor in the question, making this option incorrect as it focuses on age rather than the correct risk factor (tobacco use).
**Clinical Pearl:** In clinical practice, it is essential to consider SCC in the differential diagnosis of a fungating mass in tobacco users, even if the mass is not ulcerated and if the patient is middle-aged or elderly. Early detection and treatment are crucial in improving the prognosis for SCC patients.
**Why Option A is Right:**
The presence of a fungating mass in a tobacco user, such as this case, is a typical presentation for squamous cell carcinoma. The patient's history of tobacco chewing for 30 years further supports the diagnosis.
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**Correct Answer Explanation:**
The correct answer is **Option A (A):**
A fungating mass invading maxilla and mandible is a typical presentation of squamous cell carcinoma (SCC) in a long-term tobacco user, such as this patient. The patient's history of tobacco chewing for 30 years further supports the diagnosis. Additionally, SCC typically presents with aggressive local invasion and rapid growth, which is consistent with the described mass and its invasiveness.
**Why Option B is Incorrect:**
Alcohol consumption is not the only risk factor for SCC. The question specifically mentions tobacco use, making this option incorrect.
**Why Option C is Incorrect:**
The absence of ulceration does not rule out SCC. While ulceration is often seen in SCC, it is not a definitive sign and can be absent in some cases.
**Why Option D is Incorrect:**