A case of poorly-differentiated squamous cell carcinoma following dental extractions

A 39-year-old male patient was referred to the Oral and Maxillofacial Surgery (OMFS) department at Queen Mary's Hospital, Sidcup, by his GDP for the extraction of his lower third molars due to recurrent symptomatic pericoronitis for the past two years. The patient was assessed, examined clinically and radiographically (Figure 1) and booked for routine extractions. His medical history was clear. He smoked around eight cigarettes a day and was an occasional cannabis and alcohol user. His extractions went uneventfully. He had no initial post-operative complications; however, after three weeks he developed left-sided extra-oral facial swelling and was prescribed antibiotics by his general dental practitioner (GDP).

Two months later, he attended the A&E department at King's College Hospital, London, complaining of pain from the lower left quadrant and progressive trismus. He was clinically assessed and examined by the OMFS team and a dental panoramic tomograph (DPT) was taken with no obvious abnormal findings (Figure 2). He was given tongue spatula exercises and was offered a follow-up outpatient appointment, which he declined.