Manifestation of carcinoma cuniculatum in the mandible

Carcinoma cuniculatum (CC) is a rare variant of squamous cell carcinoma usually occurring in the lower extremity. Occurrence in the oral cavity is unusual and was reported in the literature less than 20 times. A 81 year old female presented with pain in the left mandible. Clinical examination showed no pathologic result but panoramic radiograph showed osteolytic lesion. Result of histological study was CC and local resection was done. Eight month later patient presented again with pain in the contralateral side of the mandible and follow up X-ray showed a new osteolytic lesion. Histology confirmed second occurrence of CC. CC is rare entity especially in the head and neck showing local aggressive behavior but should be considered as differential diagnosis.