Treatment options, including surgery and radiation therapy, were discussed with the owner. Although radiation therapy can effectively treat a tumor in the mandible, surgery is considered the gold standard treatment for a small tumor with a rostral location. Surgery is more likely to provide local control with the shortest treatment period, and the cost is approximately half that of radiation therapy.1 Radiation therapy may also cause mucositis, which can be markedly painful, in the oral cavity.2 Intralesional bleomycin has also been used to treat this tumor type and may lead to long-term control.3
The following week, the patient underwent wide excision of the mass with 2-cm margins based on the visible tumor mass and CT scan findings.
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Cross-match and blood typing were performed preoperatively, and a mandibular nerve block was administered bilaterally before the procedure. The surgeon used an oscillating bone saw to perform a bilateral rostral mandibulectomy (Figures 4 and 5). For closure, the gingival mucosa was attached to the lingual mucosa with an absorbable suture in a simple continuous suture pattern. A triangle of skin was excised from the midline to remove redundant tissue from the chin. Subcutaneous tissue was closed over the ends of the mandible to prevent protrusion through the closure. The skin was closed maintaining the continuity of the mucocutaneous junction.