Carcinoma verrucoso periimplantario: A propósito de un caso

Abstract

RESUMEN Introducción:Las rehabilitaciones orales sobre implantes de titanio endoóseos se han convertido en estas últimas décadas en uno de los tratamientos más frecuentes realizados hoy día en odontología con un elevadísima tasa de éxito. Aunque son muy pocos los casos, están descritos cuadros de carcinomas surgidos en tejidos blandos periimplantarios, la mayor parte de ellos como recidivas de un cán-cer oral previo tratado quirúrgicamente y rehabilitado funcionalmente con implantes. Objetivos: Se presenta el caso de un carcinoma verrucoso o tumor se Ackerman, variedad muy infrecuente de carcinoma de células escamosas (1 al 10%), que apareció alrededor de un implante dental sin antecedentes de carcinoma oral previo, lo cual está descrito de forma excepcional en la literatura. Discusión: El carcinoma verrucoso es una variante del carcinoma de células escamosas de bajo grado de malignidad. Es más frecuente en hombres por encima de los 50 años, y muy relacionado con el tabaco y el virus del papiloma humano. Su tratamiento es quirúrgico, obteniéndose pocas recidivas. Conclusiones: La simple posibilidad de aparición de esta grave patología, resalta la importancia de la eliminación de factores de riesgo y la realización de biopsias en cualquier lesión oral sospechosa como claves para evitar las graves consecuencias del cáncer oral.PALABRAS CLAVE: Carcinoma oral de células escamosas, implante dental, periimplantitis, cáncer oral.Verrucous carcinoma arund implants. Case report SUMMARY Introduction: Oral rehabilitations with endosseous titanium implants have become in recent decades one of the most common treatments performed today in dentistry with a high rate of success. Although few cases are described, there are some carcinomas arising in peri-implant soft tissues, most of them as a recurrence of a prior oral cancer treated surgically and then functionally rehabilitated with implants. Objectives: We report the case of a verrucous carcinoma, also know as Ackerman tumor, a very rare variety of squamous cell carcinoma (1 to 10%), which appeared around a dental implant with no history of prior oral carcinoma, which it is very rarely in the literature. Discussion: Verrucous carcinoma is a variant of squamous cell carcinoma with low malignancy. It is more common in men over age 50, and closely related to tobacco and human papillomavirus. Treatment is surgical, yielding few recurrences. Conclusions: The mere possibility of occurrence of this serious disease, highlights the importance of eliminating risk factors and biopsies on any suspicious oral lesion as a key to avoid the serious consequences of oral cancer.KEY WORDS: Oral squamous cell carcinoma, dental implant, peri-implantitis, oral cancer. INTRODUCCIÓNLas rehabilitaciones prostodónticas dentales con implantes osteointegrados vienen utilizándose con altas tasas de éxito (por encima del 90% a 5 años) desde las tres últimas décadas del siglo pasado.Entre las complicaciones asociadas a la utilización de implantes dentales destacan la mucositis periimplantaria, la sobreca...

Cancerous lesions in the vicinity of dental implants: a systematic review

“…Practically all patients had intraoral (N = 21) [16,17,20,21,[26][27][28][29][30]32,35,36,38,39] against extraoral cancers (n = 8) [5,9,13,26,[42][43][44][45], or potentially malignant mucosal disorders (n = 29) such as leukoplakias, erythroleukoplakias or oral lichen planus lesions [6,14,18,20,[25][26][27][28]32,[36][37][38]40]. In fact, in 5 of the aforementioned cases there was a combination of previous carcinomas and potentially malignant mucosal disorders [20,27,28,32,36,38].…”

“…In addition, in 18 cases, no risk factors were identified [6,20,22,26,30,[32][33][34]36] and in 27 cases the authors did not mention whether there were any risk factors [5,6,14,16,17,24,25,27,35,36,38,[42][43][44][45][46]. Among the remaining 33 cases, the following risk factors were identified: smoking [6,21,25,26,36,37,39] (or being an ex-smoker [18,23,28,30,32,47]), alcohol consumption [6,9,21,23,[29][30][31]39,47] (or being an ex-alcohol drinker [32]), or both [6,…”

“…One author described a clinically acceptable peri-implant appearance in one patient, while radiographically, there was radiolucency along the length of the implants [44]. Some authors describe associated cervical lymphadenopathies [19,29,32,[35][36][37]41], verrucous carcinomas [32,45], paraesthesia [36,40,43] (including numb chin syndrome [44]), pain [43], lesions that did not respond to conventional treatment [5,9,[20][21][22]35,36] and of rapid evolution [13,18,23,28,32,37,42,45], bone expansion, trismus [36], purulent drainage [43] and mobility of teeth adjacent to the implant [40] or of the implants themselves [13,32]. In one case, the presence of metal filings from the implant in the affected peri-implant mucosa was described [29] and in another, the sudden appearance of cellulitis of the mental nerve area without associated bone lesions that led to the loss of osseointegration of the implant [32].…”