Carcinoma Cuniculatum of the Maxilla Mimicking Nonhealing Extraction Sockets at the Right Molar Region - An Interesting Case.

Background: Carcinoma cuniculatum is a rare variant of squamous cell carcinoma, mostly affecting the skin but also sparsely reported to occur in the oral cavity. Oral carcinoma cuniculatum (OCC) tends to be misdiagnosed as verrucous carcinoma; this may lead to inadequate treatment and recurrence due to the locally aggressive nature of the tumor. This report presents the case of a 56-year-old man with a progressively enlarging painful OCC at the maxillary right molar region, exhibiting both exophytic (red, soft, nodular mass) and endophytic (superficial ulceration and bone exposure, mimicking nonhealing extraction sockets) growth patterns. Incisional biopsy was consistent with OCC, a diagnosis that was corroborated through histopathologic examination of the resected specimen. The patient underwent en bloc resection (segmental maxillectomy) of the tumor and prosthetic rehabilitation with an obturator and remains disease-free 2.5 years postoperatively.

Conclusions: The aim of this report is to provide a thorough clinical imaging and histopathological presentation of OCC along with a brief literature review to highlight the difficulties of accurate diagnosis and the pitfalls in treating this uncommon entity.