Case report of a huge lower lip cancer successfully treated with intra-arterial infusion chemotherapy

• Published in: International journal of surgery case reports 2020-01, Vol.71, p.82-84
• Main Authors: Sheen, Yen Ting, Chen, Yu Yuan, Sheen, Maw Chang
• Format: Article
• Language: English
• Subjects: Case report; Lip cancer; Methotrexate; Squamous cell carcinoma; Surgery
• ISSN: 2210-2612; 2210-2612
• DOI: 10.1016/j.ijscr.2020.04.034

•For lower lip cancer, early surgical excision is the treatment of choice.•A difficult case of huge SCC of the lower lip that was successfully treated by intra-arterial infusion with methotrexate.•Intra-arterial infusion chemotherapy has the advantage of delivering a high concentration of anticancer drug to the lesion.•Intra-arterial infusion achieves good tumor response to lip cancer with excellent anatomical and functional preservation. We present a difficult case of huge squamous cell carcinoma (SCC) of lower lip that was successfully treated by intra-arterial infusion with methotrexate (MTX). This 42-year-old female patient present with a fungating lower lip SCC of approximately 10 × 5 cm in size. MTX 25 mg was infused continuously to each side of external carotid artery every 24 h using two portable pumps. Totally, MTX 300 mg was given over 6 days. After treatment initiation, the tumor shrank dramatically and disappeared completely 2 months after the therapy. The patient was now recurrence-free at the recent follow-up 4 and half years after therapy. Intra-arterial infusion chemotherapy has the advantage of delivering a high concentration of anticancer drug to the lesion to induce a rapid shrinkage of the tumor and the side effects are limited. Intra-arterial infusion with MTX achieves good tumor response to lower lip cancer with excellent anatomical and functional preservation. This therapy may be a treatment option in lower lip cancers with unresectable lesions, or in those patients who are unwilling to undergo resection.