Oral Cavity Squamous Cell Carcinoma Presenting as an Isolated Nasal Mass in the Setting of a Fixed Implant–Supported Upper Denture
Proper staging and diagnosing of mucosal head and neck cancers is necessary given important differences in tumor behaviors that lead to different standards of treatment. We report the unusual case of a 65-year-old woman who is a former smoker with an implant-supported upper denture who developed an isolated nasal mass on examination, which was confirmed after resection to be a squamous cell carcinoma originating from the hard palate. Although this is a rare scenario, an oral cavity cancer should be taken into consideration in the differential diagnosis of a nasal cavity mass in the setting of a fixed upper dental implant.
CT scan of the patient's nasal cavity mass. (Top left) Coronal view demonstrating the anterior-most implants with overlying mass in nasal cavity. (Top right) Coronal view demonstrating hard palate erosion immediately posterior to the anterior-most implants. (Bottom left and bottom right) Axial views in immediate sequence showing the bone erosion in proximity to the apex of the dental implants.
Specimen was removed en bloc and included the right nasal floor, ethmoid sinus, hard palate, and maxilla, going past midline to also include the nasal septum. The blossoming tumor within the nasal cavity can be seen, which histologically was contiguous with a mucosal hard palate cancer SCC.
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