J Korean Assoc Oral Maxillofac Surg.  2024 Feb;50(1):35-40. 10.5125/jkaoms.2024.50.1.35.

Management and treatment of four cases of oral carcinoma cuniculatum

• Mourouzis C
• Toursounidis I
• Eftychiadis C
• Rallis G

• KMID: 2553660
• DOI: http://doi.org/10.5125/jkaoms.2024.50.1.35

Abstract

Objectives
Oral carcinoma cuniculatum (OCC) is a rare variant of squamous cell carcinoma (SCC). It has similar clinicopathological characteristics to SCC and verrucous carcinoma (VC). We present a case series of OCC and analyse its unique features, diagnosis, and management.
Patients and Methods
We retrospectively reviewed the medical records of oral cancer patients treated by Oral and Maxillofacial Surgery department from 2009 to 2020 with OCC biopsy findings. The clinicopathological characteristics and management of the OCC cases were analysed.
Results
Four patients were identified with histologic findings of OCC, including three on the alveolar ridge mucosa and one on the tongue. Imaging revealed that two of the lesions located in the maxilla had osseous lysis. All four patients were all treated with radical excision, and the histopathology showed findings of SCC cuniculatum. It was decided that no further treatment was necessary. None of the patients has experienced recurrence during follow-up.
Conclusion
OCC is a distinct entity that is more locally aggressive than VC but is associated with good prognosis. Radical surgical removal is considered appropriate for OCC. Emphasis should be given on an early diagnosis, as it remains challenging.

Keyword

Carcinoma cuniculatum; Oral cancer; Head and neck cancer; Oral squamous cell carcinoma

Figure

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  Fig. 1 A-D. Endophytic development of a well-differentiated squamous epithelium with minimal cytological atypia and multiple keratin-filled crypts resembling cuniculus (H&E staining, A-D: ×10).

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  Fig. 2 Clinical appearance of Case 2. A. Preoperatively. B. Postoperatively.

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  Fig. 3 Intraoral papillary lesion on the left maxillary alveolar mucosa in Case 3. A. Preoperatively. B. Three years postoperatively.

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  Fig. 4 Exophytic papillary lesion on the left buccal mucosa in Case 4.

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