Carcinoma Cuniculatum of the Alveolar Mucosa: A Rare Variant of Squamous Cell Carcinoma

Abstract

Carcinoma cuniculatum is one of the variants of squamous cell carcinoma. It is significantly rare with an incidence rate < 1% compared to other histological variants of squamous cell carcinoma. Various etiologic factors implicated are trauma, HPV, chronic inflammation and alcohol consumption but real causative agent still remains unclear. Initially it resembles plantar wart which slowly progress to bulky exophytic mass in the sole of the foot, where cases have been reported first. In the oral cavity it presents clinically as an exophytic growth and slowly invades the jaw and destroys the underlying bone. Microscopically it exhibits as both exophytic and endophytic epithelial masses along with well differentiated and pronounced hyperkeratosis. Treatment includes surgical resection alone unlike other variants which are treated by radiation with or without chemotherapy. Here we present a case of carcinoma cuniculatum occurred in alveolar mucosa of a 47 years old female. It presented as an exophytic growth in mandibular alveolar region, with histological features consistent with carcinoma cuniculatum.

Cuneiform (cuniculatum) variant of oral squamous cell carcinoma revisited: Presentation of two cases and literature review of a rare entity

“…Cuneiform variant of oral squamous cell carcinoma, more commonly known as oral carcinoma cuniculatum (OCC), is a rare entity with an incidence of <1% compared to other variants of squamous cell carcinoma 1 . Its unique histopathological architecture resembles a network of rabbit burrows, which is known as a cuniculus in Latin 1 . It poses a diagnostic challenge to pathologists because of its histologic similarity to benign cysts and abscesses 2 …”

Oral carcinoma cuniculatum, the great mimicker: Report of a challenging case and literature review

“…In nine cases (12.2%), immunohistochemical investigation for p53, Ki‐67, p16 and PCNA was also performed. Nevertheless, immunostaining for p53, PCNA and Ki‐67 was negative or weak in most tumours 13,22,23,30,37,41,42 and p16 had inconsistent results 9,21,42 . Five cases (6.8%) of OCC were included in a retrospective study of rare variants of head and neck SCC.…”

Carcinoma Cuniculatum of the Larynx

“…It occurs with elective localization in the skin of the plantar surface of the foot, followed by toes and heel [2]. Rarely CC has been described in the mucosa of the upper aero-digestive tract as well [3][4][5][6][7][8][9][10][11][12][13][14][15][16].…”

“…Even though the aetiology of this tumour is not definitely established, infection, traumatic event, chronic irritation and radiation have been variably reported as possible triggering factors and specifically in the aero-digestive tract, human papillomavirus (HPV) infection, alcohol and tobacco consumption have been considered without, however, any definitive proof [3][4][5][6][7][8][9][10][11][12][13][14][15][16].…”