Abstract
Pseudoepitheliomatous hyperplasia (PEH) is a benign proliferation of the epidermis that mimics squamous cell carcinoma (SCC), but with no atypia or mitotic figures. Herein we report on a 45-year-old male patient presenting with a mandibular osteolytic lesion with a previous diagnosis of suppurative osteomyelitis refractory to antimicrobial therapy. Cone bean CT indicated an irregular hypodense image with central hyperdense mass. Oral biopsy showed irregular trabecular bone fragments, absence of osteocytes, and presence of stratified squamous epithelial tissue between the bone trabeculae. The final diagnosis was PEH associated with chronic osteomyelitis. The lesion was treated with curettage and antibiotic for 7 days, and the follow-up included clinical examination and panoramic radiograph every 4 months for 2 years, showing complete resolution after 18 months. This report highlights the importance of distinguishing PEH from SCC, which can occur in chronic osteomyelitis, to avoid misdiagnosis and to establish the correct treatment.
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