Case report on surgical removal of 3.5 kg benign mesenchymal tumor from the mandible region

Abstract

Background
Benign mesenchymal tumors are rare tumors accounting for 5% of all salivary gland tumors and less than 10% of submandibular or sublingual gland tumors.

Case presentation
The present case study represents a rare case of large-size benign mesenchymal tumors arising from the mandible region. The patient comes with the complaint of prominent swelling on the right side of the lower jaw. Clinical history revealed that the swelling appeared around 5 years ago and enhanced over time to form a large tumor. The patient presented with signs of anemia and hypoproteinemia, which were developed due to dysphagia and bleeding in the tumor. A worm infestation was also found during the clinical examination, and severe pain, foul smell, fungating tumor, frequent pus discharge, and bleeding were also reported. The patient was treated by surgical removal of tumors within 8 h of surgery. Right segmental mandibulectomy with wide local tumor excision was performed under general anesthesia and prophylactic tracheostomy to maintain a secure airway. A huge defect of 8 cm × 6 cm was generated on the right side of the face after tumor removal, which was repaired with the help of local advancement flap reconstruction. The tumor size was 30 cm × 20 cm with a weight of 3.5 kg.

Conclusion
To our best knowledge, the present study is the first in the literature that has reported such a large tumor in the mandible region. The success of surgery presented in the current case is very rare to achieve in developing countries. By reporting the detailed procedures, the present case study will help increase the misdiagnosis, improper treatment, treatment delays, or associated complications.