title: Mandibular Destruction Secondary to Invasion by Carcinoma Cuniculatum.
abstract: Carcinoma cuniculatum is a rare form of well-differentiated squamous cell carcinoma that is often misdiagnosed. It has a propensity for local invasion and rarely metastasizes. Oral carcinoma cuniculatum is exceedingly rare, with very few reported cases in the English-language literature. Classically, its presentation mimics osteomyelitis or a dental abscess, resulting in misdiagnosis, multiple biopsy examinations, and procedures before a final diagnosis of carcinoma cuniculatum. This case report describes the case of a 71-year-old woman who was referred to the authors' clinic for evaluation of persistent pain and swelling of the mandible. Multiple biopsy examinations were negative for malignancy, and the patient was misdiagnosed with osteomyelitis and dental abscess before obtaining an accurate diagnosis of carcinoma cuniculatum. The aim of this report is to provide a thorough clinical and histopathologic report of carcinoma cuniculatum of the mandible, provide a brief review of the literature, and highlight the difficulties in arriving at this uncommon diagnosis.
authors.affiliation: Resident, Department of Oral and Maxillofacial Surgery, Boston Medical Center and Boston University School of Dental Medicine, Boston, MA.
authors.forename: Michael C
authors.initials: MC
authors.lastname: Shapiro
authors.affiliation: Chief Resident, Department of Oral and Maxillofacial Surgery, Boston Medical Center and Boston University School of Dental Medicine, Boston, MA.
authors.forename: Brian
authors.initials: B
authors.lastname: Wong
authors.affiliation: Chief, Department of Anatomic Pathology; Professor, Department of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, MA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: O'Brien
authors.affiliation: Residency Director, Department of Oral and Maxillofacial Surgery, Boston Medical Center; Assistant Professor, Boston University School of Dental Medicine, Boston, MA. Electronic address: andrew.salama@bmc.org.
authors.forename: Andrew
authors.initials: A
authors.lastname: Salama
mesh_terms: D000368:Aged; D001706:Biopsy; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D003951:Diagnostic Errors; D005260:Female; D006801:Humans; D008334:Mandible / Q000473:pathology; D008336:Mandibular Diseases / Q000175:diagnosis / Q000382:microbiology / Q000473:pathology; D008339:Mandibular Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D009361:Neoplasm Invasiveness; D010019:Osteomyelitis / Q000175:diagnosis / Q000473:pathology; D014057:Tomography, X-Ray Computed