Abstract
ABSTRACT Carcinoma cuniculatum (CC), a rare variant of oral squamous cell carcinoma, presents well-differentiated neoplastic epithelial cells infiltrating the underlying submucosal or bone tissues, forming the so-called rabbit burrows filled with keratin. A 67-year-old female patient was referred complaining of a painless tumoral mass in the left mandibular body, with several months of evolution. Previous history indicated extraction of the teeth #37 and #38 and diagnosis of chronic suppurative osteomyelitis. A deep incisional biopsy revealed CC. Due to its microscopic features, suggesting an inflammatory or reactive process, strict clinicopathological correlation is necessary for the correct diagnosis of CC.
Highlights
Carcinoma cuniculatum (CC), known as epithelioma cuniculatum, is a rare variant of oral squamous cell carcinoma (SCC), which characteristically lacks cytological malignancy[1, 2]
In 2017, the World Health Organization (WHO) classification of the head and neck tumors defined the oral CC as a neoplasm that invades the underlying subcutaneous, submucosal, or bone tissues, forming the so-called “rabbit burrows”, with keratin-filled crypts that are of utmost importance for distinguishing this neoplasm from other variants of oral SCC[1, 2, 5]
CC was originally named epithelioma cuniculatum, which was believed to be restricted to the cutaneous tissue, the plantar surface of the foot
Summary
Carcinoma cuniculatum (CC), known as epithelioma cuniculatum, is a rare variant of oral squamous cell carcinoma (SCC), which characteristically lacks cytological malignancy[1, 2]. A previous study has stated that these neoplasms represent different variants of oral SCC, and their major distinguishing features are: 1. Radiographic examination showed an osteolytic lesion with irregular and ill-defined borders (Figure 1). A deep incisional biopsy was performed, which microscopically showed an exuberant, well-differentiated squamous epithelial proliferation, with frequent invaginations, delimiting pseudocystic cavities, which was filled with parakeratin and peeled cells. The patient underwent surgical resection (Figure 3), and the specimen showed similar histopathological features. Previous dental extraction and chronic suppurative osteomyelitis were noticed in this area; B) panoramic radiograph showing an osteolytic area with irregular and ill-defined borders
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