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Case Report
Department of
Periodontology and
Oral Implantology, M. A.
Rangoonwala College
of Dental Sciences and
Research Center, Pune,
India
Abstract:
Squamous cell carcinomas of the gingiva make up a significant percentage of oral squamous cell carcinomas and
are one of the most common causes of death worldwide. Cancers of the gingiva often escape early detection,
and hence an early intervention, since their initial signs and symptoms resemble common dental and periodontal
infections. This article presents a case of a 29yearold female patient who presented with a nonhealing wound for
about 1.5months postextraction. The wound was associated with pain and suppuration. Aprovisional diagnosis
of alveolar osteitis was derived at with a differential diagnosis of osteomyelitis and carcinoma of the alveolus.
The patient was advised a complete hemogram, orthopantomograph, and intraoral periapical radiograph of the
extraction socket. An incisional biopsy was carried out. Radiographs revealed extensive bone loss, and the biopsy
report confirmed the diagnosis of welldifferentiated squamous cell carcinoma of the alveolus.Carcinoma of the
gingiva often mimics inflammatory lesions and hence is often misdiagnosed. Therefore, any oral lesion should strike
a chord of suspicion, and practitioners should base their diagnosis on careful examination, and valid evidence.
Key words:
Extraction socket, gingiva, squamous cell carcinoma
INTRODUCTION
Address for
correspondence:
Dr.Jovita Dsouza,
Department of
Periodontology and
Oral Implantology, M. A.
Rangoonwala College
of Dental Sciences and
Research Center, 2390B,
K. B. Hidayatullah road,
Azam Campus, Camp,
Pune411001, India.
Email:jovs24@gmail.com
Submission: 10032011
Accepted: 12092012
602
CASE REPORT
A 29yearold female reported to the Department
of Periodontics of M.A. Rangoonwala College
of Dental Sciences and Research Centre, in
the month of January 2010, with a complaint
of pain and bleeding gums in the right side
of the lower jaw since 1.5months. Adetailed
case history revealed that the pain started
8days following extraction of a mobile tooth
in the same region. The pain was localized and
continuous in nature. She experienced difficulty
during mastication and while brushing. The
pain also disturbed her sleep. The pain was
only transiently relieved on taking analgesics.
The patient complained of bleeding on and
off from the extraction site. The patient also
complained of halitosis. On receiving no
permanent relief despite repeated visits to her
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Sheikh and Dsouza: Squamous cell carcinoma of alveolus
DISCUSSION
INVESTIGATIONS
A complete hemogram, blood glucose estimation, intraoral
periapical radiographs (IOPA), orthopantomogram (OPG),
and biopsy were advised.
All the parameters of the hemogram and blood glucose
estimation were within the normal range.
The IOPA revealed diffuse, poorlydefined radiolucency with
ragged margins in the region associated with 46 and vertical
and horizontal bone loss with distal aspect of 45 and mesial
aspect of 47, respectively [Figure3].
The OPG revealed a diffuse, poorlydefined radiolucency
with ragged borders in relation to the region of 46, extending
inferiorly up to the mandibular canal and laterally on either
Journal of Indian Society of Periodontology - Vol 16, Issue 4, Oct-Dec 2012
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Sheikh and Dsouza: Squamous cell carcinoma of alveolus
Figure4: Orthopantomogram
Figure5: H and E section showing epithelial and keratin pearls, altered cytoplasmic
ratio, and prominent nuclei
604
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Sheikh and Dsouza: Squamous cell carcinoma of alveolus
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