Primary intraosseous squamous cell carcinoma mimicking periapical disease: a case report

Abstract

Primary intraosseous squamous cell carcinoma (PIOSCC) is a rare carcinoma, which arises within the jaws without connection to the oral mucosa and presumably develops from a remnant of odontogenic epithelium. We present a case of solid type PIOSCC in a 52-year-old male patient complaining of dull pain on his left lower molar. In this case, early stage PIOSCC mimicking a periapical lesion might lead to a one-year delay in treatment due to the misdiagnosis of osteomyelitis after extraction of the third molar. The clinical, radiological, and histologic features are described. In this case, there was initial radiographic evidence for PIOSCC mimicking a periapical lesion. Incautious radiographic interpretation and treatment procedures had delayed the correct diagnosis and resulted in extensive bony destruction during the patient's disease progression.

Primary intraosseous carcinoma, NOS in a 17‐year‐old male: case report and literature review

“…Elimination of these conditions often delays diagnosis. PIOC also superficially resembles many other routine dental disorders, such as dental infection, periodontal and periapical disease, resulting in a high occurrence of early misdiagnosis. A clinicopathologic review documented that the majority of patients receive pre‐operative dental procedures prior to a definitive diagnosis of PIOC.…”

“…Parameters established to guide diagnosis of PIOC include: (i) intraoral clinical exam does not reveal any mucosal tumours or mucosal lesions overlying the central bony mass, (ii) histologic examination notes epithelial lining transitioning into SCC, (iii) primary neoplasm at a distant site should be ruled out and (iv) physical and radiographic examination. Delayed diagnosis, and therefore delayed treatment, is directly correlated with increased bone destruction and poor prognosis, illustrating the importance of early detection.…”

Solid type primary intraosseous squamous cell carcinoma in a cat

“…Given the findings of the extensive oral examination, it was considered likely that the lesion was a result of pain or discomfort arising from the oral cavity. Although solid type PIOSCCs in humans are frequently asymptomatic, pain and jaw swelling without oral soft tissue involvement, as observed in this cat, is considered to be the main clinical features of solid type PIOSCC in humans [ 6 , 13 , 14 ].…”

Keratocystic odontogenic tumour arising as a periapical lesion

“…, Choi et al . ) and even metastatic tumours can be found in this region (Milobsky et al . , Block et al .…”

“…This study reports the case of an odontogenic lesion that involved the periapex of teeth 22 and 23 in a 55-year-old man. Although uncommon, the finding of tumours that arise as periapical radiolucencies is not surprising because benign (Morais et al 2011, Rodrigues et al 2011, malignant (Favia et al 2000, Kuc et al 2000, Chen et al 2004, Choi et al 2012) and even metastatic tumours can be found in this region (Milobsky et al 1975, Block et al 1977, Nevins et al 1988). However, although cases of odontogenic cysts and tumours that mimic periapical lesions have been previously reported (Kuc et al 2000, Cunha et al 2005, Nikitakis et al 2010, Tejasvi et al 2010, Gondak et al 2013, few cases of keratocysts in the periapical region exist (Wright et al 1983, Stajci c & Paljm 1987, Nohl & Gulabivala 1996, Garlock et al 1998, Tan 2001, Pace et al 2008, Tejasvi et al 2010, Khanna et al 2011.…”