Outcome of Treatment in Locally Advanced Upper Alveolar Carcinoma Extending to Infra-temporal Fossa.

Squamous cell carcinoma of oral cavity has a high prevalence in our region. Upper alveolar cancers are uncommon but present with locally advanced disease extending to infra temporal fossa. The outcome of treatment in these tumors is poor. Surgery followed by adjuvant therapy is the mainstay of treatment. We are presenting a retrospective analysis of outcome of treatment in 20 patients with locally advanced (T4b) upper alveolar carcinoma treated by infra-structure maxillectomy with compartment resection of infra-temporal fossa and neck dissection followed by adjuvant radiotherapy or radiotherapy with chemotherapy. Study period was from 2013 to 2018. Minimum follow up was 12 months and mean follow up 30 months. 12 patients are alive and disease free, 6 patients had local recurrence and 2 patients had regional recurrence with one having pulmonary metastasis. We observed that positive or close margins (< 5 mm after formalin fixation) predisposed to early recurrence. Erosion of pterygoid plates was a poor prognostic factor. Cervical lymph node metastasis occurred late in disease, but carried poor prognosis. Compartment resection of infra temporal fossa gave better outcome compared to other studies which reported outcome of treatment in upper alveolar cancers.

Lethal Midline Granuloma: An Enigma in Diagnosis-A Rare Case Report.

Lethal midline granuloma is a rare disease, characterised by progressive unrelenting necrosis and mutilation of nose, midline facial tissues and other respiratory passages. This particular type of disease is heterogeneous in its pathogenesis, non-specificity of symptoms obscures timely and correct diagnosis and is responsible for delay in of treatment which can be detrimental as this disease calls for immediate intervention. We present a case report of 60 year old female who gave short one-month history of clinical symptoms.