GINGIVAL CARCINOMA CUNICULATUM: RARE VARIANT OF SQUAMOUS CELL CARCINOMA OFTEN MISDIAGNOSED AS AN INFLAMMATORY PROCESS

Abstract

Carcinoma cuniculatum (CC) is a rare variant of oral squamous cell carcinoma (OSCC). To date, 50 cases of oral CC have been reported. A 67-year-old white female patient presented complaining of a painless tumor mass in the left mandibular body with several months of evolution. Previous dental history indicated extraction of teeth #37 and #38 and chronic osteomyelitis. Intraoral examination revealed an irregular exophytic mass in the region of the extracted teeth, which exhibited a yellow purulent discharge during palpation. Radiograph evidenced an osteolytic lesion with irregular and ill-defined borders. An incisional biopsy was performed, which showed an intense squamous epithelial proliferation, with frequent invaginations that delimited pseudocystic cavities filled with parakeratin and peeled cells. In the deepest part, foci of osseous resorption permeated by squamous epithelium were visualized. In conclusion, oral CC should be considered in the differential diagnosis, especially when assessing persistent "reactive inflammatory process." Carcinoma cuniculatum (CC) is a rare variant of oral squamous cell carcinoma (OSCC). To date, 50 cases of oral CC have been reported. A 67-year-old white female patient presented complaining of a painless tumor mass in the left mandibular body with several months of evolution. Previous dental history indicated extraction of teeth #37 and #38 and chronic osteomyelitis. Intraoral examination revealed an irregular exophytic mass in the region of the extracted teeth, which exhibited a yellow purulent discharge during palpation. Radiograph evidenced an osteolytic lesion with irregular and ill-defined borders. An incisional biopsy was performed, which showed an intense squamous epithelial proliferation, with frequent invaginations that delimited pseudocystic cavities filled with parakeratin and peeled cells. In the deepest part, foci of osseous resorption permeated by squamous epithelium were visualized. In conclusion, oral CC should be considered in the differential diagnosis, especially when assessing persistent "reactive inflammatory process."