Abstract
Oral carcinoma cuniculatum is a rare low-grade variant of squamous cells carcinoma, with distinct clinicopathologic outcomes. In the present case, a 63-year-old Black male patient presented with an exophytic mass in the posterior mandible gingiva for 6 months. The lesion appeared after removal of a third molar. Oral examination revealed firm exophytic verruciform growth. Radiographic exam showed irregular radiolucent lesion in the mandible, evidencing bone invasion. A biopsy was carried out with the diagnostic hypothesis of verrucous carcinoma. The initial histopathologic report was inconclusive of a mucosal fragment with papillomatosis and moderate dysplasia. A second and large incisional biopsy was conducted. Microscopically the lesion revealed atypical proliferation of keratinocytes forming multiple, complex, branching keratin-filled crypts, with a burrowing pattern. Mild cytological atypia, few mitotic figures, hyperchromatism, and low cell cohesiveness were also noted. With a final diagnosis of squamous cells carcinoma, subtype cuniculatum, the patient was referred for treatment.
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