[A Case of Diffuse Large B-Cell Lymphoma Detected Due to Ill-Fitting Dentures].

Malignant lymphoma(ML)occurring in the oral cavity are often difficult to diagnose, as their clinical presentation is non- specific and may resemble that of other malignancies or inflammatory conditions. We report a case of diffuse large B-cell lymphoma(DLBCL)detected as a result of ill-fitting dentures. The patient was an 80-year-old man. He had a medical history of chronic heart failure(NYHA class Ⅲ, after CABG), COPD, and benign prostatic hyperplasia. In the middle of February 2018, he visited a dental clinic with a chief complaint of ill-fitting dentures and was subsequently referred to our department for further examination and treatment. At the initial examination, the patient exhibited bilateral facial asymmetry and swelling extending from the right cheek to the right submandibular region, with palpable induration. These findings strongly suggested that the patient had a malignant tumor, and we clinically diagnosed him as having ML(Ann Arbor staging, Stage Ⅳ)based on various imaging studies. Histopathological examination confirmed the diagnosis of DLBCL. In consultation with the hematology department, the patient began treatment with R-CEOP therapy(administered at 50% dose due to severe cardiac dysfunction): rituximab 375 mg/m2, etoposide 50 mg/m2, vincristine 1.4 mg/m2, and cyclophosphamide 750 mg/ m2), and the patient underwent 6 courses of this therapy. However, the tumor continued to increase in size, and radical treatment was deemed difficult. In late August 2019, the patient developed ventricular tachycardia, followed by ventricular fibrillation, and subsequently died from cardiopulmonary arrest. Although oral ML are rare, it is critical for oral surgeons to promptly recognize suspicious clinical signs and initiate appropriate diagnostic procedures, including imaging and biopsy, to ensure early diagnosis and treatment.