LAUSR

Introduction White/red lesions, exophytic masses with or without ulceration, are well-recognized typical presentations of oral squamous cell carcinoma (OSCC). Rarely, clinical characteristics may mimic benign lesions. Objective To report an unusual case of OSCC of the anterior maxillary gingiva and hard palate, with an initial nonspecific clinical and histologic presentation mimicking benign inflammatory lesions. Case Presentation A 58-year-old, otherwise healthy woman was referred with mild pain and a reddish, papillary, gingivopalatal, inflammatory-like lesion of 6 months’ duration. Medications, systemic medical conditions, tobacco use, and parafunctional habits that could generate the appearance were excluded. Radiographs did not reveal any bone involvement. Repeated periodontal treatment, improvement of oral hygiene, topical applications of disinfectant, an antifungal, and corticosteroids all failed to yield any improvement. During a period of 18 months, 3 biopsies were taken from the affected gingiva, showing only benign epithelial hyperplasia with dense chronic inflammation devoid of any evidence of malignancy. Following rapidly progressing tooth mobility of the lateral incisor concomitant with accelerated overgrowth of the anterior palatal gingiva, dental radiography was repeated, and computed tomography was performed. Both revealed an extensive osteolytic lesion in the premaxilla. A new biopsy taken from the affected gingiva and adjacent maxillary alveolar bone yielded a diagnosis of OSCC. Treatment included resection of the premaxilla and floor of the nose with bilateral neck dissection. Conclusions This case emphasizes the possibility of a deceptive initial appearance of OSCC, the sudden burst and rapid disease progression, and the importance of close follow-up of unusual nonspecific inflammatory-like processes in the oral cavity.