title: Oral Adenosquamous Carcinoma Mimicking a Pyogenic Granuloma: a Challenging Diagnosis.
abstract: Adenosquamous carcinoma is an aggressive variant of squamous cell carcinoma. This report describes a case of adenosquamous carcinoma with clinical features of a benign lesion and discusses the differential diagnoses, especially regarding histopathological and immunohistochemical analyses. A 45-year-old male was referred to our outpatient clinic complaining about a rapid-growing enlargement in hard palate. Clinical examination revealed an erythematous and pedunculated nodule with lobulated non-ulcerated surface. Excisional biopsy was performed following clinical diagnosis of pyogenic granuloma. Histologically, the specimen consisted of areas characterizing both well-differentiated squamous cell carcinoma and true adenocarcinoma. After a broad list of immunohistochemical markers was evaluated (AE1/AE3, CEA, CK5, CK7, CK8/18, p53, p63 and Ki67), the diagnosis of adenosquamous carcinoma was rendered and the patient referred to complementary surgery. Adenosquamous carcinoma represents a challenge in diagnostic routine due to its rarity, diverse range of clinical presentations and histological features. Furthermore, classical clinical benign features may be present in malignant lesions; hence the submission of every surgical specimen to histological analysis is mandatory to provide the patient the adequate treatment.
authors.affiliation: University Braz Cubas, Mogi das Cruzes, São Paulo, Brazil.
authors.forename: Celina Faig
authors.initials: CF
authors.lastname: Lima
authors.affiliation: Department of Bioscience and Oral Diagnosis, São Paulo State University (UNESP), Institute of Science and Technology, São José dos Campos, SP, Brazil.
authors.forename: Renata
authors.initials: R
authors.lastname: Acay
authors.affiliation: Department of Bioscience and Oral Diagnosis, São Paulo State University (UNESP), Institute of Science and Technology, São José dos Campos, SP, Brazil.
authors.forename: Ana Lia
authors.initials: AL
authors.lastname: Anbinder
authors.affiliation: Department of Bioscience and Oral Diagnosis, São Paulo State University (UNESP), Institute of Science and Technology, São José dos Campos, SP, Brazil.
authors.forename: Janete Dias
authors.initials: JD
authors.lastname: Almeida
authors.affiliation: Department of Bioscience and Oral Diagnosis, São Paulo State University (UNESP), Institute of Science and Technology, São José dos Campos, SP, Brazil.
authors.forename: Yasmin Rodarte
authors.initials: YR
authors.lastname: Carvalho
mesh_terms: D018196:Carcinoma, Adenosquamous / Q000175:diagnosis* / Q000601:surgery; D003937:Diagnosis, Differential; D017789:Granuloma, Pyogenic / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000175:diagnosis* / Q000601:surgery