Snus (nass) and oral cancer: A case series report
An 82-year-old female, from Zahedan province, was referred by her general dental practitioner in relation to a complaint of a growth in the lower right alveolar left region since 3 months previously. The growth was insidious initially and gradually increased in size. Since the first week, the growth was associated with localized severe throbbing and pain. There was no relevant medical history. The patient had smoked up to 5 cigarettes per day for the past 20 years and had the habitual use of snus 4-5 times a day for the past 20 years in the left mandibular vestibule.\nA solitary submandibular lymph node was palpable on the left side, measuring 4 cm in size, which was tender and hard boney in consistency and fixed. Intraorally, an ulcero-proliferative lesion was evident on the left mandibular ridge area, measuring about 4 × 5 cm in size. It was irregular in shape with rolled-out edges extending to the floor of the mouth. The center of the lesion was composed of a whitish-yellow slough. The lesion was tender on palpation with an indurated base; in addition, there was evidence of a crater-like ulcer on the left vermilion border of the lip [Figures and ].\nIncisional biopsy of the lesion was performed, which provided a histopathological diagnosis of poorly differentiated squamous cell carcinoma. The patient was reviewed at monthly intervals. Despite radical surgery and radiotherapy, the patient died 5.5 months after presentation.