An old man who is edentulous, presents with squamous cell carcinoma in buccal mucosa that has developed and infiltrated to the alveolus. Following is not indicated in treatment:
**Core Concept**
Squamous cell carcinoma (SCC) of the buccal mucosa is a type of oral cancer that originates from the squamous epithelium of the buccal mucosa. The tumor has infiltrated to the alveolus, indicating local invasion and potential spread to regional lymph nodes.
**Why the Correct Answer is Right**
In the management of SCC of the buccal mucosa, wide local excision with adequate margins is crucial to prevent recurrence. The tumor has infiltrated the alveolus, so a segmental resection of the involved alveolus and surrounding tissue is necessary. This approach allows for the removal of the tumor with a margin of normal tissue, reducing the risk of local recurrence. The use of radiotherapy or chemotherapy may also be indicated in cases with advanced disease or lymph node involvement.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect as it is unclear what "conservative excision" entails, but it may not provide adequate margins for tumor removal.
**Option B:** This option is incorrect as it is unclear what "biopsy alone" would accomplish in the treatment of an infiltrative SCC.
**Option C:** This option is incorrect as "chemotherapy alone" may not be sufficient for treating a locally advanced SCC with alveolar involvement.
**Option D:** This option is incorrect as "radiotherapy alone" may not be sufficient for treating a locally advanced SCC with alveolar involvement.
**Clinical Pearl / High-Yield Fact**
In the management of oral cancers, the goal is to achieve wide local excision with adequate margins to prevent recurrence. The use of adjuvant radiotherapy or chemotherapy may be indicated in cases with advanced disease or lymph node involvement.
**Correct Answer: D. Radiotherapy alone.**