Univ. Bordeaux, CHU Bordeaux, Service de Chirurgie Maxillo-Faciale et Stomatologie, Centre François Xavier-Michelet, Groupe Hospitalier Pellegrin - CHU Bordeaux, Place Amélie Raba-Léon, 33076, Bordeaux CEDEX 33000, France.
Univ. Bordeaux, CHU Bordeaux, Service de Chirurgie Maxillo-Faciale et Stomatologie, Centre François Xavier-Michelet, Groupe Hospitalier Pellegrin - CHU Bordeaux, Place Amélie Raba-Léon, 33076, Bordeaux CEDEX 33000, France.
J Stomatol Oral Maxillofac Surg. 2024 Sep;125(4):101729. doi: 10.1016/j.jormas.2023.101729. Epub 2023 Dec 7.
Carcinoma cuniculatum (CC) is a rare variant of squamous cell carcinoma (SCC). Lack of awareness of this tumor and its difficult diagnosis delay management and complicate treatment. The aim of this study is to describe the clinical and histological features, predisposing factors, treatment and survival rate of oral carcinoma cuniculatum.
MATERIAL & METHOD: All patients with histologically confirmed CC of the oral cavity treated between January 2013 and August 2022 in a specialized center were retrospectively included. Patients were identified using the database ADICAP ("Association pour le Développement de l'Informatique en Cytologie et Anatomie Pathologique"). Once identified, the charts were reviewed.
Ten patients were included. CC lesions were mainly located in the mandibular or maxillary gingiva, while the 2 remaining lesions were located in the mobile tongue. The tumor showed local aggressiveness: mandibular or maxillary osteolysis was systematically found for gingival CC, while tongue lesions were classified cT3. Fifteen biopsies were performed in these 10 patients, histological diagnosis is difficult on a limited tissue sample. All patients underwent curative management with oncological excision surgery combined with neck lymph node dissection, and adjuvant radiotherapy (except one patient).
The main problem is the difficulty of diagnosis when biopsies are performed, which leads to a significant delay in diagnosis compared with SCC. In the event of clinico-histological discordance after biopsy, CC should be considered.
窝状角化不良癌（CC）是一种罕见的鳞状细胞癌（SCC）变体。由于对这种肿瘤缺乏认识，其诊断困难，导致管理延迟，治疗复杂化。本研究旨在描述口腔窝状角化不良癌的临床和组织学特征、诱发因素、治疗方法和生存率。
回顾性纳入 2013 年 1 月至 2022 年 8 月在一家专门中心接受组织学确诊为口腔 CC 治疗的所有患者。使用数据库 ADICAP（“Association pour le Développement de l'Informatique en Cytologie et Anatomie Pathologique”）识别患者。识别后，查阅病历。
共纳入 10 名患者。CC 病变主要位于下颌或上颌牙龈，而另外 2 处病变位于活动的舌头上。肿瘤表现出局部侵袭性：下颌或上颌骨质溶解在牙龈 CC 中普遍存在，而舌部病变则被归类为 cT3。这 10 名患者中进行了 15 次活检，在有限的组织样本上进行组织学诊断具有一定难度。所有患者均接受了以肿瘤切除手术联合颈部淋巴结清扫术为基础的治愈性治疗，且均接受了辅助放疗（除 1 名患者外）。
主要问题是活检时的诊断困难，这导致与 SCC 相比，诊断明显延迟。如果活检后出现临床与组织学不一致的情况，应考虑 CC。
