Abstract
Conventional oral squamous cell carcinomas are readily recognized histopathologically but the presence of additional atypical features may be challenging from a diagnostic point of view. We present a case of a well-differentiated oral squamous cell carcinoma with pseudo-glandular differentiation and discuss the possible differential diagnoses on a histopathological basis. Accurate diagnosis is imperative for timely and appropriate intervention and denotes distinctive prognostic implications. The presence of perivascular and perineural infiltrations as observed in this case would indicate the need for further post-operative therapeutic decision-making aimed at controlling local spread as well as distant metastases.
Highlights
Squamous cell carcinoma (SCC) is the most common form of oral malignancy and majority present as welldifferentiated or conventional keratinizing squamous cancers
Adenoid features could be present in several types of carcinoma, complicating the interpretation of tissue sections which may lead to misdiagnosis
Adenosquamous carcinoma of the head and neck was first defined by Gerughty et al in 1968 but its existence as a distinct entity remained controversial for many years as some investigators regarded it a high grade mucoepidermoid carcinoma (6)
Summary
Squamous cell carcinoma (SCC) is the most common form of oral malignancy and majority present as welldifferentiated or conventional keratinizing squamous cancers. The patient was a non-smoker but suffered a myriad of medical problems including hypertension, benign prostatic hyperplasia, unrepaired right inguinal hernia, chronic constipation, chronic hyponatremia, major depression complicated by obsessive-compulsive disorder-like symptoms, suspected early dementia, treated glaucoma and cataract. He had a history of repeated falls and sustained fractured fingers and clavicle. There was an ulcerated swelling at the buccal sulcus in the region of teeth 45, 46 and 47 It measured approximately 5cm x 5cm and extended upwards towards the upper dentition and lower edentulous area. Patient was last seen in OMFS clinic two weeks post operatively
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