Rare presentation of gingival squamous cell carcinoma of maxillary posterior region mimicking pyogenic granuloma in a non-smoker – A case report

Gingival Squamous cell carcinoma (GSCC) in maxilla is a rare malignant neoplasm especially when compared with mandible. The most common sites of oral carcinoma are being the lateral border of the tongue and the floor of the mouth which is followed by palate, buccal mucosa and rarely in gingiva. The clinical picture of oral carcinoma can be misguided for gingival overgrowth, desquamative lesions, traumatic ulcers or even pyogenic granuloma. Maxillary oral gingival carcinoma is a rare entity especially in a non-smoker. In this case report, a 70-year-old male patient presented with a gingival lesion in maxilla 24,25 region mimicking pyogenic granuloma without having a tobacco history. A thorough clinical, radiographical and histopathological examination was done and led to the diagnosis of GSCC and the treatment was initiated.Creating awareness among practitioners about gingival squamous cell carcinoma mimicking pyogenic granuloma in dental practice.

Expression of Neurokinin B Receptor in the Gingival Squamous Cell Carcinoma Bone Microenvironment

Gingival squamous cell carcinoma (SCC) frequently invades the maxillary or mandibular bone, and bone destruction is known as a key prognostic factor in gingival SCCs. Recently, Neurokinin 3 receptor (NK-3R), the receptor ligand for NK-3, which is a member of the tachykinin family expressed in the central nervous system, was identified through pathway analysis as a molecule expressed in osteoclasts induced by the hedgehog signal. Although the expression of NK-3R has been detected in osteoclast and SCC cells at the bone invasion front, the relationship between NK-3R expression and the prognosis of gingival SCC patients remains unclear. In the present study, we retrospectively reviewed 27 patients with gingival SCC who had undergone surgery with curative intent. Significantly higher NK-3R expression in tumor cells was found in a case of jawbone invasion than in a case of exophytic poor jawbone invasion. On the other hand, no significant association was observed between NK-3R tumor-positive cases and tumor size, TNM stage, or tumor differentiation. The survival rate tended to be lower in NK-3R tumor-positive cases, but not significantly. However, the disease-specific survival rate was significantly lower in patients with a large number of NK-3R-positive osteoclasts than in those with a small number of them at the tumor bone invasion front. Our results suggest that NK-3R signaling in the gingival SCC bone microenvironment plays an important role in tumor bone destruction and should be considered a potential therapeutic target in advanced gingival SCC with bone destruction.

PERIPHERAL ODONTOGENIC FIBROMA: MIMICKING GINGIVAL SQUAMOUS CELL CARCINOMA: A RARE CASE REPORT AND REVIEW OF LITERATURE

In neoplasms Peripheral Odontogenic Tumors(POT) are one of the rare to occur on gingiva, among them, Peripheral Odontogenic Fibroma (POdF) is the most common. A plethora of lesions sharing similar clinical features, makes the diagnosis difcult. POdF is a benign, slow-growing, smooth, exophytic, painless lesion but it may show diverse clinical presentation as erythematous, lobulated, rapidly growing mass which might be tender on palpation overlapping the features with various inammatory gingival conditions to even a gingival squamous cell carcinoma.This results into diagnostic enigma. Histopathologoical examination plays a vital role in these type of cases. Discussed here is a case of POdF mimicking gingival squamous cell carcinoma. Histopathological investigation showed presence of odontogenic epithelium and dystrophic calcication which are the pathognomonic features of POdF. After surgical removal,POdF is seen to recur but, the exact recurrence rate cannot be estimated due to scarcity of reported cases.

Prognostic Exploration of All-Cause Death in Gingival Squamous Cell Carcinoma: A Retrospective Analysis of 2076 Patients

Background. We aimed to establish a prognostic model for gingival squamous cell carcinoma (GSCC) that was superior to traditional AJCC staging and to perform a comprehensive comparison of the newly established nomogram with the AJCC staging system. Methods. We extracted 2,076 patients with gingival squamous cell carcinoma who had been entered into the SEER (Surveillance, Epidemiology, and End Results) database between 2004 and 2015, and randomly divided 70% of them into the training cohort and the other 30% into the validation cohort. Cox regression analysis was performed in combination with clinical experience and age, race, sex, marital status, tumor location, histological subtype, tumor grade, AJCC stage, chemotherapy status, radiotherapy status, and surgery status as possible prognostic factors. We evaluated and compared the two cohorts using the consistency index (C-index), area under the receiver operating characteristic curves, calibration curves, discriminant improvement index, and decision-curve analysis. Results. The Cox retrospective analysis showed that age, AJCC stage, tumor grade, histological subtype, radiotherapy status, and surgery status were significant factors to include in the new model of gingival squamous cell carcinoma. The other indicators were also better for the new model than for the AJCC staging system. Conclusion. We have developed and validated a nomogram for performing reliable gingival squamous cell carcinoma prognoses. The prognostic value of the nomogram is higher than that of the AJCC staging system. We expect that the inclusion of more-comprehensive and authoritative data (i.e., not just limited to residents of the United States) would also allow the construction of reliable nomograms for other populations.