CASE STUDY -6
Name: Mrs. S B Sex/Age: F 42 yrs
Religion: Hindu Marital status: Married
Occupation: House wife Residence: Dineshpur
History of Presenting Illness
The lady presented with a growth in upper palate causing difficulty in eating, chewing and mastication. The pain tumar tend to extend to forehead. She developed ulcer in hard palate which indurated into a bony hard tumor and was diagnosed as Squamous cell carcinoma hard palate. The lady was having habit of chewing tobacco and beetle for past 30 years.
Recurrent tonsillitis in childhood. Led a very poor and tough life full of cares and worries.
Patient as a Person
Appearance Moderate built
Skin Clean, dark complexion
Cravings Salt +++, Tobacco+++
Emotional State Irritable, sad, wants not to be disturbed, indifferent about house hold affairs and family members.
Menses Menopause last year
Pulse 70 /Min.
Respiratory rate 16 /Min.
Blood pressure 128/84 mm Hg
Weight 49 kg
Respiratory system NAD
Cardiovascular system S 1- S2 Normally heard, no
Local examination Large Swelling in hard palate with excision- mark of biopsy taken.
Biopsy- Growth-Hard Palate Specimen sent as hard palate
Dated 03-12-2003 at tumor shows features of
AIIMS, New Delhi moderately differentiated Suqamous cell carcinoma grade 2.
Moderately differentiated Squamous cell carcinoma hard palate grade 2
Mentals Aversion to company
Indifferent about family members and domestic works
Desires Tobacco, Salt, sweets
Food Aggravation None
Physical Generals Moderate body
Menses Menopause one year ago
Pain of lancination type in bony hard growth of hard palate. < drinking anything hot, cold, solid or liquid. Pain extending to root of nose and forehead. < nights
Fundamental miasm Syphilis
Dominant miasm Psora+
(Careful, chilliness etc.)
(Company aversion to, sour aversion to, tissue destruction, irritability)
(Salt desires, Inflammatory Changes, chilliness, moderate built etc.)
Good oral hygiene, highly nourishing diet rich in.
Strict control on any other medication, beetles, tobacco etc.
Sati Bairagi F 42 Squamous cell carcinoma Hard Palate
Prominence - Prominence - Intensity is considered
S. no. Intensity Rubrics Remedies
1 2 MIND - INDIFFERENCE - household affairs 8
2 2 MIND - INDIFFERENCE - family, to his 25
3 1 MIND - IRRITABILITY 642
4 1 MIND - DISTURBED; averse to being 23
5 1 MIND - AILMENTS FROM - cares, worries 25
6 1 GENERALS - CANCEROUS affections 177
7 1 GENERALS - CANCEROUS affections - advanced stage 32
8 2 GENERALS - FOOD and DRINKS - salt - desire 158
9 2 GENERALS - FOOD and DRINKS - sweets - desire 280
10 1 GENERALS - TOBACCO - desire for tobacco 79
11 1 GENERALS - FOOD and DRINKS - sour food, acids - aversion 60
12 1 MIND - COMPANY - aversion to 293
13 1 GENERALS - PSORA 222
14 1 GENERALS - SYCOSIS 185
15 1 GENERALS - SYPHILIS 182
16 2 GENERALS - FAMILY HISTORY of - cancer (&Elimination) 8
carc. con. brom. carb-an. scir. trif-p. cund. calc-ar.
514 392 300 286 199 199 197 144
1 - - 1 - - - - -
2 - - - - - - - -
3 1 2 1 1 - - - 1
4 - - - - - - - -
5 1 1 - - - - - -
6 1 3 3 3 2 1 2 -
7 - 1 - - 1 - - -
8 2 2 - - - - - -
9 1 - - - - - - -
10 - 1 - - - - - -
11 - 2 - - - - - -
12 1 2 1 3 - - - -
13 1 1 - 2 - 1 - -
14 1 1 - 1 - - - -
15 - 2 - 2 - - 1 -
16 2 1 1 1 2 2 1 1
Date Carcinosin 1 M stat
20- 01- 2004 Sac Lac TDS
Criteria General symptoms, family history matched.
Mental and Physicals similar.
Comment Little better. Mild bleeding.
01-02-2004 Hekla lava 30 TDS
Criteria Bony hardness of the tumor.
Comment Much more improvement.
18-02-2004 Hekla lava 30 TDS
Criteria Second photograph. Much better in all respects.
Comment Marked improvement. Growth regressed.
Date 30-03-2004 Hekla lava 30 TDS
Criteria Marked improvement. Gland almost disappeared. Third photograph
Photograph on 20-01-2004 Photograph on 18-02-2004
Photograph on 30-03-2005
Anatomical and Pathological Discussion
The palate, or oral roof, is divisible into two regions: the hard palate in front and soft palate behind.
The hard palate is formed by the palatine processes of the maxillae and the horizontal plates of the palatine bones. It is bounded in front and at the sides by the superior and inferior arches of the alveolar processes and gums, and is continuous posteriorly with the soft palate. The hard palate is covered by a thick mucosa bound tightly to the underlying periosteum, its more lateral regions also possessing a submucosa containing mucous glands and (anteriorly) adipose tissue. Its covering of stratified squamous epithelium is orthokeratinized. The periphery of the hard palate consists of gingiva and a zone similarly lacking submucosa runs anteroposteriorly in the midline as a narrow, low ridge, the palatine raphe.
Squamous cell carcinoma
Oral cavity - Risk factors include tobacco and alcohol for oropharynx and sunlight and smoking for lip. Multifocality common. Prognosis related to stage, grade, and location. Better prognosis for tumors arising in lip, floor of mouth, cheek, hard palate and gingiva. Worst prognosis for oropharynx,
Irregularly shaped nests and clusters of squamous cells invading stroma, often with eosinophilic cytoplasm, atypical nuclei with coarse chromatin, prominent nucleoli, abnormal mitotic figures. Keratinizing tumors with more abundant keratin production.
Therapy and prognosis related to clinical stage. Frequent recurrence of tumor. Overall 5-year survival rate is approximately 60%.