Snus (nass) and oral cancer: A case series report
A 78-year-old Iranian female was referred to the Department of Oral Medicine, Kerman Dental School, by her dentist for evaluation of an exophytic lesion on the right buccal mucosa, which had been noticed 2 months previously. The lesion had rapidly increased in size. The patient did not have any systemic disease. In addition, the patient had a snus habit for the past 15 years in the right mandibular vestibule but no alcohol consumption.\nOn examination, there was a tender firm exophytic lesion with induration, measuring 8 cm by 4 cm, on the right buccal mucosa. The surface of the lesion was verrucous with a white color and no associated lymphadenopathy [].\nA diagnosis of verrucous carcinoma with differential diagnosis of a squamous cell carcinoma was made. Under local anesthesia, simple enucleation of the lesion was performed. Histological examination of the excised tissue showed features of a poorly differentiated verrucous carcinoma. In view of the diagnosis of verrucous carcinoma, further investigations including chest radiography and hematological and biochemical blood tests yielded negative results. Surgery, chemotherapy and radiotherapy were considered for the patient. Further, histological examination of the main specimen confirmed the presence of a verrucous carcinoma with parakeratin and the wide and elongated rete ridges that appear to push into the underlying connective tissue []. A year later, the patient passed away despite removal of the lesion and a relatively good response to treatment.