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Case Report: Malignant Transformation of Noma: Repair by Forearm Flap
Xiang Ding1, Qian-Qian Wang2, Yang Zhou3
11Department of Stomatology, The Second Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui Province, China.
Abstract:
Noma is a progressive infectious disease manifested by a necrotic ulcer of the mouth and face. It usually occurs in poor, malnourished children, with about 30,000-140,000 cases each year and a low survival rate. The exact cause of noma remains unclear, but bacterial infection has been postulated to be a major cause of this disease. Antibiotics and improved nutrition could help inhibit the progression of noma, but most patients still require oral surgery because of the bacterial infection-induced tissue damage. In this study, we report an unusual case of a noma patient whose facial lesion developed a malignancy. The necrotic tissue and infectious area were surgically resected, and a forearm flap was used to repair the patient's facial defect. This case aimed at increasing people's awareness of tropical diseases such as noma.
Insights
Noma, a severe infectious disease, can lead to facial tissue destruction. This case highlights a rare instance of noma developing malignancy, requiring surgical intervention and reconstruction.
Area of Science:
- Infectious Diseases
- Oral Surgery
- Oncology
Background:
- Noma is a neglected tropical disease causing facial necrosis, primarily affecting malnourished children.
- Bacterial infection is suspected as the main cause, with high mortality and morbidity.
- Standard treatment involves antibiotics and nutritional support, often followed by reconstructive surgery.
Observation:
- This report details an unusual case of noma with a secondary facial malignancy.
- The patient presented with a necrotic ulcer characteristic of noma, complicated by cancer.
- Surgical resection of the diseased tissue was performed.
Findings:
- The noma-induced facial lesion progressed to malignancy.
- Successful reconstruction was achieved using a forearm flap after tumor and infection removal.
- This case underscores the complex pathology that can arise from noma.
Implications:
- Increased awareness of noma's potential complications, including malignancy, is crucial.
- Early diagnosis and comprehensive management, including surgery and reconstruction, are vital for noma patients.
- Further research into noma's etiology and oncogenic potential is warranted.
