Lack of Awareness and Self-Neglect in a Patient with Suspicious Tongue Squamous Cell Carcinoma: Case Report

Ninety percent of malignant tumors that present in the mouth are squamous cell carcinoma (SCC). It may affect any anatomical site in the mouth, but most commonly found on the lip, ventral or lateral tongue and the floor of the mouth. These lesions are seen as red, white, red-white, exophytic, or ulcerative lesions. The various problems such as patient personality, social environment and symptoms of the disease can be influenced the awareness and delay of the diagnosis thereby affecting the prognosis of SCC. A suspect case of SCC was found in a 71-years old female who came to Faculty Dental Hospital of Universitas Indonesia with a chief complaint of swollen and easily bleeding gingiva for one month on the left mandible. Intraoral tumor lesions exist in the region 35, 36, 37 of the alveolar left mandible with indentation of tooth antagonists on the dorsal surface and also the irreversible white plaque lesions with reddish erosive lesions on the lateral and ventral left tongue with induration extending to the left floor of the mouth. Chronic gingivitis and radix also founded. For the management, patient was given the information about SCC and motivation involving her family also oral hygiene care instructions. Then the patient was referred to an Oncologist and administered of chlorine dioxide mouthwash and multivitamin. Cytological was performed and malignant squamous cells were discovered. After tumor excision, the patient refused chemotherapy, but unfortunately, she died seven months later. As a conclusion, lack of awareness and self-neglect in SCC is reflected by the extent of the tumor and it requires more aggressive treatment which tailored to patient's condition and involves co-operation of other competent colleagues.