CARCINOMA CUNICULATUM OF THE ALVEOLAR RIDGE

Abstract

Carcinoma cuniculatum (CC) is a rare, well-differentiated variant of oral squamous cell carcinoma that usually affects the mucoperiosteum of older patients. Oral CC appears mainly as locally destructive tumors with superficial drainage of keratin, with low risk of metastasis. A 56-year-old white woman, a nonsmoker and nondrinker, presented a nonhealing gingival ulcer with duration of 2 months. Intraoral examination showed a well-defined irregular ulcer in the posterior upper alveolar ridge with drainage of a whitish material suggestive of keratin during palpation. Periapical radiograph showed an ill-defined osteolytic lesion. Microscopic evaluation showed well-differentiated proliferation of squamous epithelium with mild cytologic atypia exhibiting multiple infiltrative and branching keratin-filled epithelial crypts. Oral CC may appear as an irregular ulcer in the alveolar ridge with drainage of whitish material, which may be clinically similar to benign inflammatory diseases of the jaws. Carcinoma cuniculatum (CC) is a rare, well-differentiated variant of oral squamous cell carcinoma that usually affects the mucoperiosteum of older patients. Oral CC appears mainly as locally destructive tumors with superficial drainage of keratin, with low risk of metastasis. A 56-year-old white woman, a nonsmoker and nondrinker, presented a nonhealing gingival ulcer with duration of 2 months. Intraoral examination showed a well-defined irregular ulcer in the posterior upper alveolar ridge with drainage of a whitish material suggestive of keratin during palpation. Periapical radiograph showed an ill-defined osteolytic lesion. Microscopic evaluation showed well-differentiated proliferation of squamous epithelium with mild cytologic atypia exhibiting multiple infiltrative and branching keratin-filled epithelial crypts. Oral CC may appear as an irregular ulcer in the alveolar ridge with drainage of whitish material, which may be clinically similar to benign inflammatory diseases of the jaws.