Yoon Thomas Y H, Bhattacharyya Indraneel, Katz Joseph, Towle Herbert J, Islam Mohammed N
Department of Periodontics, University of Florida, College of Dentistry, Gainesville, USA.
Quintessence Int. 2007 Feb;38(2):97-102.
Gingival squamous cell carcinoma represents less than 10% of diagnosed intraoral carcinoma. Many unique features of gingival squamous cell carcinoma clearly delineate it from oral squamous cell carcinoma arising in other sites. This article presents the clinicopathologic findings of a case. An 81-year-old woman presented for evaluation of multiple oral lesions primarily limited to the maxillary gingiva; the lesions had been present for about 2 years. Differential diagnosis included epithelial dysplasia, benign mucous membrane pemphigoid, inflammatory lesion of endodontic/periodontic origin, lichen planus, and squamous cell carcinoma. Clinical examination revealed extensive erythematous and ulcerative lesions of maxillary buccal and palatal gingiva extending into the maxillary buccal vestibule; the lesions did not respond to antibiotic therapy. Radiographic evaluation demonstrated advanced alveolar bone loss as well as displacement of the maxillary right first molar. Subsequent histology confirmed diagnosis of moderately differentiated squamous cell carcinoma. Gingival squamous cell carcinoma can mimic a multitude of oral lesions, especially those of inflammatory origin. In addition, predisposing and presenting factors are different from those of other oral squamous cell carcinomas. Careful examinations as well as routine biopsy are crucial for accurate diagnosis.
牙龈鳞状细胞癌占已确诊口腔癌的比例不到10%。牙龈鳞状细胞癌的许多独特特征使其与发生于其他部位的口腔鳞状细胞癌明显区分开来。本文介绍了1例的临床病理表现。一名81岁女性因主要局限于上颌牙龈的多处口腔病损前来就诊；这些病损已存在约2年。鉴别诊断包括上皮发育异常、良性黏膜类天疱疮、牙髓/牙周源性炎性病变、扁平苔藓和鳞状细胞癌。临床检查发现上颌颊侧和腭侧牙龈广泛的红斑和溃疡性病变，延伸至上颌颊侧前庭；这些病损对抗生素治疗无反应。影像学评估显示牙槽骨严重吸收以及上颌右侧第一磨牙移位。随后的组织学检查确诊为中分化鳞状细胞癌。牙龈鳞状细胞癌可模仿多种口腔病损，尤其是炎性起源的病损。此外，其易感因素和表现因素与其他口腔鳞状细胞癌不同。仔细检查以及常规活检对于准确诊断至关重要。
