Clinicians from the University at Buffalo may have saved a 48-year-old man from an unexpected stroke or heart attack by examining and diagnosing a malignant lesion on his gums. Unforeseen complications after the removal of a cancerous tumor lead to the subsequent diagnosis of protein S deficiency, a disorder whereby the body's natural-occurring anticoagulants are not able to prevent blood clotting.
"Identifying oral cancer in this patient was really a blessing in disguise," said Dr. Alfredo Aguirre, professor of oral and maxillofacial pathology at the State University of New York at Buffalo. "Fortunately, survival rates for this type of cancer are high when found in its early stage, but undetected protein S deficiency causes thrombotic disorders that obstruct blood flow thereby causing strokes and/or heart attacks."
He added, protein S deficiency is classified as an acquired or heredity disorder, and occurs in approximately 1 out of 10,000 people when it is hereditary.
"A periodontal examination saved this patient's life," said Aguirre. "If the protein S deficiency had not been detected, eventually, the patient would have experienced an unforeseen stroke or heart attack, and his chance of survival would have been unpredictable."
The case, featured in the October Journal of Periodontology, describes how a 48-year-old male experiencing discomfort in his gums visited the University's dental school for a consultation. After a periodontal examination, Dr. Sebastian Ciancio, chairman of Periodontology at the State University of New York at Buffalo, found a lump on the patient's gums and biopsy results determined it was squamous cell carcinoma, the most common cancer of the oral cavity and oropharynx. The patient was referred to a head and neck surgeon who removed the remaining gum tissue and part of the jawbone and repaired the area with a tissue and bone graft. After the surgery, physicians noticed that the graft was not healing properly. Blood flow tests found vein clots in the graft and additional blood tests revealed that the patient's levels of protein S were extremely low.
"This clearly shows the value of a comprehensive periodontal examination in detecting serious oral and systemic conditions," said Gordon Douglass, DDS, president of the American Academy of Periodontology. "Any unusual changes in your mouth such as swelling, redness or bleeding should be evaluated by your dentist or periodontists today. Early diagnosis of any medical condition is the key to successful treatment outcomes."
