A Rare Case of Malignant Transformation of Oral Lichen Planus of the Mandible.


Oral lichen planus (OLP) is an immune-mediated mucocutaneous disease associated with an increased risk in oral squamous cell carcinoma (OSCC). Nearly all cases of malignant transformation have been reported in patients >40 years old. We report the case of a 37-year-old woman with a 5-year history of erosive OLP who presented with malignant transformation to OSCC. Delineating the margins of the disease was impossible at presentation given her OLP, and she was initially treated with concurrent chemoradiation therapy. She then developed a recurrence of the mandibular alveolar ridge. The patient was successfully treated with a composite resection including a segmental mandibulectomy, buccal mucosa resection, partial glossectomy, and ipsilateral neck dissection. This was reconstructed with a free fibula osteo-septo-cutaneous flap. Mandibular OSCC is a rare complication of OLP with few reports on effective reconstructive interventions. The case represents the youngest reported patient with mandibular OSCC arising in the context of OLP and highlights the utility of the free vascularized fibula graft in the treatment of these patients.






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Publication Info

Soo, Joanne, George Kokosis, Michael Ogilvie, Xiaoyin Sara Jiang, David B Powers, Daniel J Rocke and Detlev Erdmann (2016). A Rare Case of Malignant Transformation of Oral Lichen Planus of the Mandible. Plastic and reconstructive surgery. Global open, 4(12). p. e1070. 10.1097/gox.0000000000001070 Retrieved from https://hdl.handle.net/10161/25659.

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David Bryan Powers

Professor of Surgery

Dr. Powers currently serves as a Professor of Surgery, and Director of the Craniomaxillofacial Trauma Program, at Duke University Medical Center.  Additionally, he is the Fellowship Director for the Craniomaxillofacial Trauma and Reconstructive Surgery fellowship within the Department of Surgery. His surgical experience in facial trauma was attained during a military career highlighted by the acute management of ballistic and other injuries of warfare, as well as performing secondary and tertiary facial reconstructive surgery during various staff assignments at Wilford Hall USAF Medical Center, the Walter Reed National Military Medical Center – Bethesda and the R Adams Cowley Shock Trauma Center in Baltimore, Maryland.  He lectures and has published extensively on the management of ballistic and high-energy transfer injuries to the craniomaxillofacial skeleton, comprehensive reconstruction techniques for facial trauma, and the use of computer-aided surgical planning and patient-specific implants for anatomic rehabilitation after catastrophic craniomaxillofacial injuries.


Detlev Erdmann

Professor of Surgery

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