CASE REPORTS

Complex care by multiple medical and dental specialists of a patient with aggressive Gorlin–Goltz syndrome

K Nagy¹, E Kiss², C Erdei³, F Oberna⁴, P Fejérdy³, K Márton³, Z Vajo¹

¹ Department of Oral and Maxillofacial Surgery, University of Szeged, Szeged, Hungary
² Private Practice, Kecskemet, Hungary
³ Department of Prosthodontics, Semmelweis University Medical School, Faculty of Dentistry, Budapest, Hungary
⁴ Department of Maxillofacial Surgery, Saint Rokus Hospital, Budapest, Hungary

Correspondence to:
Dr Z Vajo, Department of Oral and Maxillofacial Surgery, University of Szeged, Szeged 6720, Hungary; zoltanvajo{at}gmail.com

Gorlin–Goltz syndrome is a genetically predisposed disease characterised by multiple basal cell carcinomas, odontogenic keratocysts and ectopic calcifications. The aim of this study was to show successful treatment of a 37-year-old male patient by cooperation between different dental and medical specialists. Because of the recurrence of a large basal cell carcinoma after multiple operations and a total dose telecobalt irradiation of 66 Gy, the patient’s nose was ablated, with resection of the upper lip and part of the maxilla. The intraoral prosthetic treatment helped to restore the subtotal edentulousness. In order to enhance the application of the dental prosthesis, an Abbe plasty was performed at the second stage of surgery. As previous irradiation of the area precluded the use of facial implants immediately after the intraoral treatment, a temporary artificial nose prosthesis was created. The patient tolerated the procedures well and is completely disease-free 12 months after the surgery. Besides presenting a rare and complicated case of Gorlin–Goltz syndrome, the main purpose of this report is to show that, if different specialists in a dental–clinical team (maxillofacial surgeon, oncologist, radiation oncologist, prosthodontist and psychiatrist) combine their skills and expertise, successful management is possible even in a challenging complex case.

Keywords: Gorlin–Goltz syndrome; basal cell carcinoma; skin neoplasms; rehabilitation; maxillofacial prosthesis

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