Introduction:
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).
Presentation of case:
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.
Discussion:
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.
Conclusion:
This therapy may be a treatment option in lower lip cancers with unresectable lesions, or in those patients who are unwilling to undergo resection.