title: Primary Oral Malignancy Imitating Peri-Implantitis.
abstract: OBJECTIVE
  To describe new cases of primary malignancy arising around dental implants.
  
  
  METHODS
  Three patients presented with asymptomatic lesions around longstanding dental implants that resembled peri-implantitis. One case was primary large B-cell lymphoma and the remaining cases were primary squamous cell carcinoma in patients with oral lichen planus. The literature was reviewed for cases mimicking peri-implantitis.
  
  
  RESULTS
  Of 42 implant-associated malignancies reported from 2000 through 2014, 85.7% were squamous cell carcinoma (69% primary and 9.4% metastatic). Most patients presented with pre-existing risk factors for oral cancer. Lymphoma was not associated with dental implants.
  
  
  CONCLUSIONS
  Primary and metastatic malignancies can occur in peri-implant mucosa, often with clinical and radiographic features resembling peri-implantitis. Clinicians should have a high index of suspicion for changes in peri-implant mucosa in patients with existing risk factors; however, rare cases such as lymphoma might present outside this risk population. Histopathologic analysis should be included in the management of selected peri-implant lesions to avoid delayed diagnosis of malignancy.
authors.affiliation: Senior Surgeon, Oral and Maxillofacial Surgery Unit, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel.
authors.forename: Vadim
authors.initials: V
authors.lastname: Raiser
authors.affiliation: Department Head, Department of Oral and Maxillofacial Surgery, The Baruch Padeh Medical Center, Poriya, Israel.
authors.forename: Immad
authors.initials: I
authors.lastname: Abu-El Naaj
authors.affiliation: Department Head, Unit of Oral and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center; Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Shlomi
authors.affiliation: Professor and Division Head, Division of Otolaryngology and Head and Neck Surgery, Tel-Aviv Sourasky Medical Center; Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors.forename: Dan M
authors.initials: DM
authors.lastname: Fliss
authors.affiliation: Professor, Institute of Pathology, Tel-Aviv Sourasky Medical Center, Tel-Aviv; Goldschleger School of Dental Medicine; Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel. Electronic address: Dr.ilanakaplan@gmail.com.
authors.forename: Ilana
authors.initials: I
authors.lastname: Kaplan
mesh_terms: D000368:Aged; D001706:Biopsy; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007573:Jaw Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D016393:Lymphoma, B-Cell / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D057873:Peri-Implantitis / Q000175:diagnosis; D012307:Risk Factors