Periapical mucoepidermoid carcinoma: a case report with review for diagnosis and insights for dental rehabilitation

Abstract

Periapical radiolucent lesions may represent a challenge in daily clinical practice because many cystic lesions and tumors sometimes surround teeth with compromised pulp. In this paper, we have shown an uncommon manifestation of mucoepidermoid carcinoma, firstly due to its intraosseous involvement and secondarily to involve the maxillary bone around the apex of molar teeth without pulp vitality on clinical tests. An incisional biopsy was the goal of this diagnosis. The mucous and epidermoid cells lining a cystic cavity, and the marginal minor salivary glands also showing proliferative foci of these tumoral cells, led to the diagnosis of mucoepidermoid carcinoma on histopathology. A respective approach was made as primary treatment, which resulted in a bucconasal communication. An obliterating removable prosthesis was conducted over the office approach, significantly improving speech and swallowing as shown. The discussion pointed out here highlights the case and the literature hot topics for diagnosis of periapical radiolucencies, objectifying to guide the clinicians reviewing the current state of the art. The structured diagnostic approach used here and illustrations of the new case are suitable to achieve this objective.